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Query: UMLS:C1258215 (ileus)
 4,389 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Operative intestinal intubation with Miller-Abbott-tube was performed on 188 patients from 1974 to 1988 in the Surgical Department of Dresden Academy of Medicine. In a retrospective analysis, the advantages and disadvantages of the method in treating the adhesion ileus are described and complications and lethality after predominantly orthograde nasal intestinal intubation are discussed. Exact indications and various operational details may help to reduce complications due to the tube-method to a minimum. The relatively high postoperative lethality (22.3%) was mainly caused by cardiopulmonary illness and peritonitis and does not result from the operative procedure. The fact that no early recurrent bowel obstruction was observed may be stated as an essential result, even though a relaparotomy due to late recurrence had to be made within 1 to 5 years after the first operation in 4% (8 patients) of 188 intestinal intubations.
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PMID:[Intubation of the small intestine in ileus. Technic, results, complications]. 276 52

The diagnosis of a small intestinal obstruction was made prenatally between the 31st and 36th week of pregnancy in 7 patients with neonatal ileus. Five newborns showed a meconium-peritonitis, a meconium-ileus and the last a ileal atresia. These were compared with newborns with small intestinal obstruction, which had not been diagnosed prenatally. The analysis of our hospital information indicates, that primarily serious forms of ileus and intestinal perforations are diagnosed prenatally, whilst isolated small intestinal obstruction often avoids diagnosis. For this reason, diagnostic punctation of the foetal abdomen contribute little to the establishment of the etiology of the obstruction and should be avoided. On the other hand, punctation of a foetal ascites can, through pressure reduction of the abdomen, lengthen the duration of pregnancy and permit a spontaneous birth.
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PMID:[Prenatally diagnosed intestinal obstruction--contribution of pediatric surgery]. 277 52

Although dehydrated obstructing mucus is thought to account for the obstructive pathology involving the lungs, the pancreas, the reproductive system, and the intestinal tract, its relationship with CF-associated liver disease remains largely hypothetical and little is known about possible risk factors. Complete clinical and autopsy records were available in 38 of 73 deaths occurring over a 10-year period. The liver was normal in only five cases, and they were all infants. Steatosis was the only lesion present in 9, hypoxic liver disease was documented in 8, and biliary cirrhosis in 16 (focal in 10 and multilobular in 6). There was no relationship between the presence of cirrhosis, gallbladder abnormalities, age at death, and clinical status recorded during the year precoding their demise. Mucus plugs characterized by amorphous eosinophilic material within proliferated bile ductules were present in 75% of children with focal or multilobular biliary cirrhosis as opposed to 14% in those without (p = 0.015). A history of meconium ileus or its equivalent was recorded more frequently (p = 0.038) in those with cirrhosis. Finally, biliary cirrhosis was invariably present when there was a history of meconium ileus or its equivalent and when mucus plugs were noted. These findings suggest that patients with intestinal obstruction are at greater risk for the development of cirrhosis and that strategies should be developed to increase the detergent capacity of bile and its flow in order to decrease the viscosity of mucus in the biliary tree.
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PMID:Meconium ileus and its equivalent as a risk factor for the development of cirrhosis: an autopsy study in cystic fibrosis. 277 65

Fifty patients with fibrotic small bowel strictures secondary to long-standing Crohn's disease underwent a total of 225 strictureplasties during the period from June 1984 to July 1988. Forty-two patients (84%) presented with obstructive symptoms. Patients had a 1- to 30-year history of Crohn's disease (mean, 14 years). Sixty-two per cent of patients were taking steroids at the time of admission, and 70% had had previous small bowel resections. All patients had one or more areas of small bowel affected with a fibrotic stricture and partial obstruction. Short strictures were treated by Heinecke-Mikulicz strictureplasties, and longer strictures by Finney side-to-side strictureplasties. In 30 patients (60%), 6- to 65-cm segments of small bowel were also resected due to acute inflammation with phlegmon or fistulae. Patients were discharged from the hospital 5 to 20 days after operation (mean, 10 days). After operation all patients with obstructive symptoms reported relief of symptoms and weight gain. Steroid doses could be tapered and nutritional parameters, such as total lymphocyte count, and serum albumin improved. Strictureplasty had 0% mortality and 16% morbidity rates. Complications included 3 enterocutaneous fistulae, 2 intra-abdominal abscesses, 2 hemorrhages requiring transfusion, 1 prolonged postoperative ileus that could be treated conservatively in 2 patients, and 1 restricture of a strictureplasty. Patients were followed for 1 to 40 months after operation (mean, 8 months). Resection of small bowel disease, especially that associated with perforation, is usually required in Crohn's disease. However, strictureplasty minimizes the need for bowel resection in patients with short fibrotic strictures resulting in recurrent small bowel obstruction.
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PMID:Strictureplasty in Crohn's disease. 281 31

The prenatal diagnosis of cystic fibrosis is based on microvillar enzymes values in amniotic fluid taken by amniocentesis at precisely the 17-18 weeks gestation age (15-16 weeks developmental age). In pregnancies with a cystic fibrosis affected fetus the values of the enzymes are depressed. Since microvillar enzymes are normal constituents of amniotic fluid, it is important 1. to have highly reproducible techniques and 2. to determine the range of the normal values and their variations in relation to the development of the fetus. Prenatal diagnosis was performed in more than 200 pregnancies with a 1 in 4 risk of cystic fibrosis and was based on significant modifications of 6 amniotic fluid enzymes values: gamma-glutamyl-transpeptidase, aminopeptidase and alkaline phosphatase (total and isoenzymes). Normal outcome was predicted in 135 pregnancies reaching term, 133 babies were normal and 2 were affected. On the basis of significantly abnormal enzymatic values an affected fetus was predicted in 57 pregnancies, 3 went to term, the infants were affected, 54 were terminated and the diagnosis of cystic fibrosis was confirmed in the examined fetuses. The decrease in amniotic fluid microvillar enzymes values is the result of an obstruction of the terminal ileum. Fetuses affected with cystic fibrosis developed an intestinal obstruction around the 15th week of developmental age which can be seen by ultrasound scanning in about fifty per cent of the cases. This obstruction persists in some fetuses and leads to a meconium ileus at birth.
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PMID:[Prenatal diagnosis of mucoviscidosis: biochemical technics and studies of affected fetuses]. 288 Jun 76

Intestinal obstruction in the early post-operative period may be difficult to diagnose clinically and on plain abdominal radiographs with failure to distinguish obstruction from ileus. During the last 11 years we have examined 14 patients with the enteroclysis technique (small bowel barium enema) for suspected early postoperative small intestinal obstruction. Evidence of obstruction was demonstrated in all cases, the site of obstruction was clearly shown in most patients, and the cause identified in 5.
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PMID:Enteroclysis in the diagnosis of intestinal obstruction in the early postoperative period. 291 Jul 42

A working familiarity with the management of common perioperative gastrointestinal complications is required for all general gynecologists. Thermal gastrointestinal injury requires resection of the damaged portion of bowel unless the injury involves only the bowel serosa and is less than 0.5 cm in diameter. Small intraoperative lacerations of the intestine can be closed primarily, whereas larger lacerations often require resection. Some degree of postoperative ileus may be expected, but prolonged ileus requires nasogastric suctioning while excluding bowel obstruction, peritonitis, or electrolyte imbalance. Small-bowel obstruction, most likely to be caused by postoperative adhesions, can often be treated successfully by gastrointestinal intubation. Steps required in the initial management of an enterocutaneous fistula include institution of parenteral nutritional supplementation and antibiotics, skin protection, and investigative studies of the fistula. Preventive measures may be used at the time of any surgical procedure to reduce the incidence of many of these complications.
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PMID:Gastrointestinal complications in gynecologic surgery: a review for the general gynecologist. 304 3

Acute intestinal obstruction caused by gallstones: we report about our own experience with 13 patients and discuss this topic by referring to the current literature. Since there is indeed a tendency towards multimorbidity in our high-aged population, a gallstone ileus should always be included in the differential diagnosis of acute intestinal obstruction in the elderly. We put emphasis on a less traumatic operative procedure (enterolithotomy). Good results can be achieved (in terms of postoperative mortality) by operating at the early onset of symptoms.
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PMID:[Gallstone ileus--is it possible to reduce the still high mortality rate? An analysis of personal cases and review of the literature]. 306 11

Apple peel deformity of the small bowel is a variant of jejunal atresia with a high mortality. Forty five percent of these patients can be expected to die, most from anastomotic leaks with sepsis, or anastomotic failure with prolonged ileus and malnutrition. This report documents survival of three consecutive patients treated by an adaptation of the Santulli "chimney" anastomosis. This method accomplishes the goals of relief of intestinal obstruction, minimal resection, and preservation of tenuous intestinal blood vessels. All three patients had a benign postoperative course and made an uneventful recovery. Intestinal function is normal in each patient at 1 1/2 years. Based on this experience, it appears that a Santulli jejunojejunostomy combined with total parenteral nutrition offers the most promising operative strategy in the treatment of patients with apple peel bowel.
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PMID:Apple peel jejunal atresia. 310 85

Four newborn patients with congenital syphilis and intestinal obstruction are discussed in this report. In three cases, the obstruction was due to inspissated meconium, simulating the features of meconium ileus in one, meconium plug in the second, and associated with perforation of the terminal ileum in the third. An exocrine pancreatic insufficiency and a motility disturbance of the intestine due to syphilitic infection during fetal life could be the probable etiologic factor. The fourth patient had multiple ileal stenoses. Ischemia due to the prenatal syphilitic arteritis of the bowel wall can be responsible for this pathology. Attention is drawn to the association between congenital syphilis and neonatal intestinal obstruction.
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PMID:Intestinal obstruction in the newborn with congenital syphilis. 318 93


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