[SECONDARY ATRESIA OF THE SMALL INTESTINE FOLLOWING OPERATIONS FOR INTESTINAL OBSTRUCTION].
Explore the source record for details and available documents.
Humans↗
SEARCH · Search PubMed
Results for “Intestinal Obstruction”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
[Chronic intestinal obstruction due to primary stenosing tuberculosis of the small intestine].
Explore the source record for details and available documents.
Adult↗
Intestinal obstruction as first symptom of carcinoma of the large intestine.
Explore the source record for details and available documents.
Cecum↗
Intestinal obstruction in patients with advanced ovarian cancer.
A retrospective analysis of the management of intestinal obstruction in 31 patients with advanced ovarian carcinoma is described. Between 1981 and 1992 31 patients developed intestinal obstruction after their initial treatment. Nineteen patients underwent surgery, while the remaining 12 were treated conservatively. Careful evaluation with contrast studies of both the small intestine and colon is recommended to improve the prediction of site(s) of obstruction, and may reduce the number of unsuccessful operative procedures. Fifteen of the surgically treated patients survived for a period of 60 days or more. The majority, 13, were discharged to their homes after an average hospital stay of 24 days. Major postoperative complications occurred in three of the 19 patients. There was no surgical-related mortality. Two patients died within 30 days postoperatively (urosepsis and advanced tumor). While the median survival in the 19 surgical treated patients was 109 days (range 15-775), the conservatively treated 12 patients survived for a mean of 37 days (range 6-260). Surgical management of intestinal obstruction in selected cases is feasible and improves quality of life substantially.
Journal Article↗
Acute intestinal obstruction due to small gut hemangioma.
A 20-year-old man presented with acute intestinal obstruction due to multiple hemangiomas of small intestine extending into the adjoining mesentery. The diagnosis was made at laparotomy and subsequently confirmed on histology. Occurrence of hemangioma in the small intestine and its presentation as acute intestinal obstruction are rare.
Acute Disease↗
Risk factors of mortality after surgical treatment of intestinal obstruction in patients having prior laparotomy for non-malignancy.
BACKGROUND: Intestinal obstruction has remained one of the most common surgical emergencies, and its clinical spectrum has shifted in past decades. The factors contributing to its surgical mortality were studied in these selected patients with a view to finding pointers which help surgeons to identify patients with high surgical risk of mortality. METHODS: Those adult patients who had prior laparotomy for non-malignancy and were operated on for intestinal obstruction were included and studied retrospectively. Thirteen possible risk factors, including co-existing medical illness, tachycardia, preoperative shock, age, bowel ischemia, operative complication, leukocytosis, durations from symptom onset to hospitalization, from hospitalization to operation, and from symptom onset to operation, prior laparotomy number, time interval from last laparotomy to this operation, and operation method, were analyzed using univariate analysis and, then, multivariate analysis to find out the independent risk factors for surgical death. RESULTS: Adhesion-related etiologies were the most common. Still, one-tenth of cases were not adhesion-related. Obstruction in the small bowel (172/176) was more frequent than in the large bowel (4/176). The surgical mortality rate was 6.8% (12/176). The independent risk factors of mortality after surgical treatment were co-existing medical illness, bowel ischemia, preoperative shock, and operative complication. Old age seemed to be a risk factor on univariate anlaysis, but not on multivariate analysis. Duration from symptom onset to hospitalization, from hospitalization to operation, or from symptom onset to operation was not significantly related to surgical mortality. CONCLUSIONS: High risk patients could be identified by 4 independent factors: coexisting medical illness, bowel ischemia, preoperative shock, and operative complication. Old age itself was not an independent risk factor.
Adolescent↗
[Subacute intestinal obstruction caused by giant bladder diverticulum].
A case of a patient affected with intestinal obstruction of 4 days of evolution is presented. The diagnosis of giant bladder diverticulum due to Benign Prostatic Hypertrophy was made by abdominal ultrasound at Emergency Room, and afterwards was confirmed by cystography. A trabeculated wall and a diverticulum at the posterior side was seen with the cystography. The diverticulum full of urine couldn't be emptied due to a narrow diverticular neck and the rectum was obstructed. When a urethral catheter was put in, the symptoms of intestinal obstruction disappeared 800 ml of urine were passed through the catheter and the rectum compression was released; the gas was allowed to pass through the bowel and it's seen in plain X-Ray. This case is presented, considering its unusual this way of presentation of a giant bladder diverticulum. We have reviewed the literature en Medline since 1966 and we have not found a similar case.
Acute Disease↗
Current spectrum of intestinal obstruction.
In a 12-month prospective study incorporating four neighbouring district general hospitals, 228 patients required a total of 236 admissions with intestinal obstruction. The aetiological factors included adhesions 75 (32 per cent), malignant disease 61 (26 per cent), strangulated hernias 59 (25 per cent), volvulus 10 (4 per cent), acquired megacolon 6 (3 per cent), pseudo-obstruction 4 (2 per cent), faecal impaction 6 (3 per cent) and miscellaneous 15 (6 per cent). The peak incidence for obstruction due to adhesions, malignant disease and strangulated hernias each occurred in the eighth decade. Surgery was performed within 48 h of admission in 29 per cent adhesive obstructions (22), 30 per cent obstructions due to malignant disease (18) and 68 per cent strangulated hernias (40)--bowel resection rates in these three groups were 13.5, 50 and 29 per cent, respectively. The overall mortality was 11.4 per cent (26 deaths) and postoperative mortality was 12.3 per cent (19 deaths). During the 12-month study period, 228 patients required a total of 2993 inpatient hospital days as a result of intestinal obstruction. Postoperative adhesions have become the commonest cause of intestinal obstruction but strangulated hernias and intra-abdominal malignant disease still account for 50 per cent of all cases and mortalities. Obstruction due to strangulated hernias and intra-abdominal malignant disease typically occurs in the elderly age group where a more aggressive policy of elective surgical intervention is likely to be associated with increased postoperative morbidity and mortality.
Abdominal Neoplasms↗
Chronic intermittent intestinal obstruction from a seat belt injury.
Most patients with intestinal obstruction have had previous surgery. Rarely, the development of adhesions and resulting small bowel obstruction is attributed to previous intra-abdominal trauma. We present the case of a young man, without a history of surgery, who had been a restrained driver in a motor vehicle crash. Seven years later, the patient had an intermittent partial small bowel obstruction that recurred over the next 5 years. We review the pathophysiology and epidemiology of similar occurrences, as well as diagnostic options.
Abdominal Injuries↗
Prenatal detection of intestinal obstruction: deficient amniotic fluid disaccharidases in affected fetuses.
Amniotic fluid samples from four fetuses with intestinal obstructions (two anal imperforations, one duodenal atresia and one multiple intestinal atresia) were deficient in disaccharidase activities. These results indicate that disaccharidase assay in amniotic fluid can be used as a rapid and simple test for the prenatal detection of fetal intestinal obstructions.
Amniotic Fluid↗
Intestinal obstruction with strangulation of the small bowel.
The records of 128 patients operated on for adhesive complete mechanical obstruction of the small intestine were retrospectively reviewed. The gut proved to be strangulated in 53 cases, irreversibly in 16 and reversibly in 37, while 75 patients had simple obstruction (12, 29 and 59%). Continuous abdominal pain was more common in strangulation than in simple obstruction and leukocytosis was most common in irreversible strangulation (both differences significant). But no preoperative clinical parameter was specific for strangulation obstruction. Preoperative hospital stay greater than 25 hours was significantly more common in irreversible strangulation obstruction than in the other groups. Strangulation was preoperatively recognized in only 25% of the cases. The overall mortality rate was 5.5%, but with no statistical intergroup difference, possibly because so few patients died. The study showed that strangulation usually is unrecognized preoperatively, and that early operation is essential for obstruction due to intestinal strangulation. Early surgery is therefore indicated in most cases clinically diagnosed as intestinal obstruction.
Adolescent↗
Polyamines in the response to intestinal obstruction.
The gastrointestinal mucosa immediately proximal to an intestinal obstruction becomes hyperplastic. Since mucosa that is distal to an obstruction atrophies, it appears that the adaptational response to obstruction is regulated by local factors. The hypothesis tested in these studies is that increased polyamine metabolism in the gut proximal to an obstruction is a required local event in the hyperplastic process. Ligation of either rat ileum or colon resulted within 66 h in a doubling of total RNA, DNA, and protein content in the 2 cm of mucosa immediately proximal to the tie. The trophic response was accompanied by an increase in primary amine content of the intestinal chyme in the segment of gut under investigation. These amines were not removed from intestinal chyme by 24 h of lyophilization, suggesting that the more volatile short-carbon-chain aliphatic amines were of limited importance. Subsequent studies focused on polyamine metabolism. Ornithine decarboxylase (ODC) activity was increased in the mucosa proximal to obstruction. In the ileum, ODC activity was increased 10-fold over control values and in the colon about 2-fold. Increased ODC activity was accompanied by corresponding increases in mucosal polyamine content. Finally, treatment of rats with difluoromethylornithine, a selective, irreversible inhibitor of ODC, partially prevented the trophic response to intestinal obstruction.
Animals↗
Pattern of intestinal obstruction in Khartoum.
We operated on 138 patients for intestinal obstruction. The different causes are discussed and their pattern of occurrence is compared with that reported from England and other African countries. The 27.6% mortality rate was closely associated with the 28.2% incidence of gangrene. Factors which may lower this high mortality rate are enumerated.
Adolescent↗
[Neurohumoral changes in acute intestinal obstruction].
Neurohumoral changes were studied in 431 patients with acute intestinal obstruction and in experiments in 165 small laboratory animals with the model of small intestine ileus. The results were obtained on the basis of estimation of the concentration of catecholamines, acetylcholine-like substances, serotonine, histamine, their metabolism products in blood plasma and of the cardiointervalography data. The neurohumoral changes were shown to appear as early as the initial stage of the disease and to be progressing when the disease period became longer. The prevailing sympathetic activity was dependent on the decreased acetylcholine-like substances in blood plasma and tissues. The serotonine and histamine metabolism changed depending on the stage of the disease.
Acute Disease↗
Traumatic diaphragmatic hernia and intestinal obstruction due to penetrating trunk wounds.
We have reported two cases of intestinal obstruction due to traumatic diaphragmatic hernia, both resulting from apparently trivial knife wounds. When TDH is due to a penetrating injury, it tends to produce symptoms of intestinal obstruction. A high index of suspicion, a chest x-ray film, and barium studies of the gastrointestinal tract are usually needed to make the diagnosis, though CT scans, ultrasonography, laparoscopy, and radionuclide scanning may also be useful. Surgeons and emergency physicians should be aware of the potential for TDH when there is a history of a penetrating wound of the chest or abdomen.
Adolescent↗
[Intestinal obstruction after child abdominal surgery (author's transl)].
From 1957 to 1978, 211 intestinal obstructions were treated at Hôpital des Enfants malades, Paris: 103 coming from our own surgery, 108 from other surgical centers. 24,6% cases are observed in children less than one year old, after neo-natal surgery. 41% are observed between 5 and 9 years of age, at the "appendicitis period". 61% obstructions follow an appendicectomy. 74% of obstructions happen in the first year after surgery, of which 32% in the first month (the early mechanical intestinal obstruction between 8 days and 7 years after the first obstruction: 72% in the first year, of which 30,5% within the first month. Some precisions are given about clinical symptoms, site and intestinal lesions. The study of the preventive surgical procedures (Noble's, or Child-Philip's technics) are not included in this paper.
Abdomen↗
Fatal intestinal obstruction in the mentally handicapped.
In a retrospective study of hospital records over a 50-year period, data on 32 patients who died as a result of intestinal obstruction are presented and compared with comparison groups and national mortality statistics. There was a higher incidence and lower mean age at death of fatal intestinal obstruction compared with the total national population. The mean age at death significantly increased over the study period. Intestinal volvulus was a common cause of obstruction particularly in those with cerebral palsy. There was a high prevalence of chronic constipation and megacolon. Foreign-body obstruction was de facto related to pica, but overall, there was a low prevalence of pica. Overall, mean IQ was low, but only significantly so in the male subjects. The length of acute illness was short; in 22 patients it was less than 24 h. Vomiting and abdominal distension were often absent and abdominal signs were recorded only in five patients. Pain or distress was recorded in only nine patients. Only eight patients were correctly diagnosed before death and only two had surgery. The results suggest that fatal intestinal obstruction is more common in mentally handicapped people and chronic constipation and megacolon are risk factors. Intestinal obstruction in mentally handicapped people can present late and with deceptively minimal signs and symptoms.
Adolescent↗
Determination of bile acid concentration in human amniotic fluid for prenatal diagnosis of intestinal obstruction.
Bile acid concentration was measured in amniotic fluid obtained for standard indications from 11 healthy pregnant women without polyhydramnios (28 to 42 weeks of gestation) and from 9 patients with polyhydramnios (28 to 38 weeks of gestation). Two of the latter women delivered infants with intestinal obstruction distal to the papilla of Vater, a condition that causes regurgitation of bile into the amniotic fluid. In the women without polyhydramios, the total bile acid concentration ranged from 1.4 to 2.4 micronmol/liter. In the seven patients with polyhydramnios not associated with fetal intestinal obstruction, the bile acid concentration in amniotic fluid was not significantly different (0.9 to 1.9 micronmol/liter). By contrast, the bile acid concentration in amniotic fluid specimens from the two patients with polyhydramnios who gave birth to children with intestinal obstruction was considerably elevated (30.3 to 83.1 micronmol/liter). These findings suggest that determination of bile acid concentration in amniotic fluid permits prenatal diagnosis of intestinal obstruction distal to the papilla of Vater.
Amniotic Fluid↗