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

Acute pseudo-obstruction of the colon is a probably often misdiagnosed type of ileus, the diagnosis of which follows from the clinical pattern with the signs of a mechanical ileus, the acute course and the x-ray signs. Radiological findings cannot be clearly interpreted without knowledge of the clinical pattern and the course of the disease. Hence, the radiological correlate of the pseudo-obstruction of the colon is not specific, but it does supply a pointer to the disease of its shows dilation of the caecum, colon ascendens and colon transversum with air-pockets and reflected imaging as well as a usually not dilated colon descendens with remarkably little air. To make the diagnosis quite sure we must exclude intestinal obstruction by using x-ray contrast media or by coloscopy. Early diagnosis is important because of the danger of perforation of the massively dilated colon (lethality up to 60%) and good prognosis if therapy is initiated in time via compression by a Dennis sound (success rate 90%). To control the success of the treatment there must be a 24-hour x-ray follow-up to avoid the risk of perforation of the colon. In this manner it becomes possible to spare the usually elderly and multimorbid patients an operation at an enhanced risk.
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PMID:[Acute pseudo-obstruction of the colon]. 321 66

Intestinal obstruction is always accompanied by intestinal hypersecretion. This phenomenon explains the initial symptoms like bilious vomiting and abdominal distension as well as the later clinical signs of hypovolaemia and shock. The proximal hypersecretion in intestinal obstruction is incompletely understood and in the surgical literature on ileus only little attention has been paid to this crucial observation. In analogy to secretory diarrhea and because of own clinical observations we conclude that bowel contamination caused by intestinal stasis is mainly responsible for the increased intestinal secretion in bowel obstruction.
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PMID:[The significance of pathophysiologic principles of intestinal secretion for the diagnosis and therapy of ileus]. 323 39

A woman of 60 years of age with acute abdominal pain, vomiting, constipation and radiological signs of small bowel obstruction was subjected to sonographic examination. Careful examination of the entire abdomen demonstrated a hyperechoic object within the distended terminal ileum with an intensive acoustic shadow. The gallbladder was not visible. This strongly suggested gallstone ileus, especially since the patient had a history of gallbladder disease. She was treated immediately by enterotomy and extraction of a noncalcified obstructing stone. The value of ultrasound in detecting gallstones causing small bowel obstruction is discussed.
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PMID:[Ultrasonic detection of gallstone ileus]. 329 66

Between September 1, 1982 and January 31, 1986, a study was undertaken in a total of 111 patients to assess the efficacy of ultrasonography in diagnosing intestinal obstruction and ileus. In 109 cases (98%), ultrasonography provided the correct diagnosis. In one case, obstruction was correctly suspected. In another case, the diagnosis was false negative. In 51 cases (46%), ultrasonography yielded the causative diagnosis. Ultrasonography was especially rewarding in the diagnosis of X-ray-negative intestinal obstruction, very high obstruction, clinically concealed incarcerated femoral hernias and in the differentiation of intestinal obstruction and ileus in the postoperative course. Ultrasonographic differential diagnosis was a reliable guideline for adequate treatment modalities in pertinent cases, thus contributing to therapeutic success.
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PMID:Ileus and intestinal obstruction--ultrasonographic findings as a guideline to therapy. 331 21

Patients with concomitant ovarian cancer and bowel obstruction were studied in an effort to find objective prognostic factors predictive of patient outcome. A total of 62 patients were followed from 31 to 354 weeks, and a total of 20 variables were considered in the analyses. At the end of the study 49 patients were dead of their disease, and 13 were alive (six disease free and seven with persistent disease). Survival probabilities of the sample were 79% at 6 weeks, 48% at 20 weeks, and 24% at 104 weeks. Univariate analyses revealed no significant difference in the survival times of medically versus surgically treated patients; age greater than 60 years at diagnosis of cancer, presence of ascites, low serum albumin levels, elevated blood urea nitrogen levels, elevated alkaline phosphatase levels, lack of previous radiotherapy (p less than 0.002 for all), advanced tumor stage, normal/ileus x-ray results, and a short diagnosis to obstruction interval (p less than 0.04 for all) resulted in lower survival probabilities.
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PMID:Bowel obstruction in patients with ovarian cancer: a search for prognostic factors. 334 1

We report two infants with cystic fibrosis (CF), presenting with meconium ileus and meconium plug, who had no clinical or biochemical evidence of pancreatic insufficiency during infancy. They underwent pancreatic secretory function testing at 11 and 9 months of age, respectively. Both patients had sufficient lipase and colipase secretion to maintain normal digestion of fat, confirming that meconium disease in CF does not necessarily imply pancreatic insufficiency and the need for enzyme supplementation in infancy. Nonetheless, we documented markedly reduced enzyme secretion in both patients, implying a potential role for the pancreas in the pathogenesis of meconium disease, even when clinical pancreatic insufficiency is absent. In addition, our patient with meconium ileus had a severely limited fluid secretory capacity (10.3% of mean normal values). In contrast, the patient with the milder presentation of meconium plug had a far greater ability to secrete fluid (75% of mean normal), but had poorer pancreatic proteolytic activity. We suggest that impaired fluid secretion may be a very significant factor in the pathogenesis of meconium ileus, and we speculate that an inability to maintain sufficient intraluminal fluid relative to the degree of pancreatic proteolytic deficiency may more adequately explain the risk of occurrence and the severity of intestinal obstruction in CF than either factor alone.
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PMID:Pancreatic function testing in meconium disease in CF: two case reports. 335 10

A gastric balloon was endoscopically implanted in seven over-weight (36-58%) patients to achieve weight reduction on an out-patient basis. During the period of observation four patients spontaneously passed the balloon transanally, one after brief intestinal obstruction with abdominal cramps and vomiting, another with the development of ileus, which responded to eight days of conservative treatment. The occurrence of such not insignificant side effects suggests that at present the use of endoscopic implantation of gastric balloons is not a reasonable way of treating obesity.
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PMID:[Endoscopic implantation of a gastric balloon--a method of weight reduction with few complications?]. 338 57

Content of cytochromes P-450 and b5 as well as activities of amidopyrine demethylase, aniline hydroxylase and NADPH cytochrome c reductase were studied in liver tissue of rats with occlusive and strangulational ileus. Distinct inhibition of main microsomal enzymes activity and decrease of cytochromes content in hepatocytes occurred independently on the type of acute intestinal obstruction. Within early periods after surgical operation of the acute intestinal obstruction all the alterations observed were maintained especially distinctly in the strangulational type of the disease.
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PMID:[State of the microsomal oxidative system of the rat liver in acute intestinal obstruction]. 342 Jul 99

An oral intestinal lavage solution has been successfully used in the treatment of six patients with chronic distal intestinal obstruction syndrome (previously referred to as meconium ileus equivalent) complicating cystic fibrosis and a further case of recurrent small bowel obstruction. The patient with recurrent obstruction is unusual in having no evidence of pancreatic maldigestion, which previously has been considered a prerequisite for the syndrome.
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PMID:Distal intestinal obstruction syndrome in cystic fibrosis treated by oral intestinal lavage, and a case of recurrent obstruction despite normal pancreatic function. 343 97

Over a 4-year-period, 117 patients had 139 intestinal operations performed in a gynaecological oncology unit. Most of the patients had gynaecological malignancy as the indication for their operation, but 18% had a gastrointestinal primary and 10% had benign pelvic conditions which required intestinal surgery. Most of the patients with malignancy had an ovarian primary cancer. The next most common primary site was the gastrointestinal tract and here carcinoma of the sigmoid colon was the most common. There were 102 large bowel and 36 small bowel operations. Sixteen patients had more than one intestinal procedure. The most common complication of the intestinal operations was prolonged ileus which occurred in 9 instances. Three patients required repeat laparotomy for postoperative bowel obstruction. There were 3 postoperative deaths occurring within 30 days. An assessment of the usefulness of preoperative investigations showed that there was a 10.3% false negative result reported from X-rays, scans or endoscopies. This factor makes it imperative that the surgeon operating on gynaecological malignancy should be capable of dealing with intestinal surgical procedures when required as it is not possible to rely on preoperative investigations to point out those that may require intestinal surgery.
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PMID:Intestinal surgery in gynaecological oncology. 345 66


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