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At least 325 records · Page 18Linked to original sources
PubMed2004

Long-term results of the antegrade continent enema procedure for constipation in adults.

OBJECTIVE: The aim of this study was to evaluate the long-term results of the Antegrade Continent Enema (ACE) procedure for treating severe constipation in adults. METHODS: Over 10 years 37 ACE conduits were created in 32 patients (median age 35 years, 26 women) with constipation caused by slow transit, obstructed defaecation or both. Conduits were created from the appendix (n = 20, 54%), ileum (n = 10, 27%), neoappendix caecostomy (n = 5, 14%) or colon (n = 2, 5%). Clinical records were retrospectively reviewed to determine outcome. RESULTS: After a median follow up of 36 (range 13-140) months, 28 (88%) required at least one further procedure on a primary conduit, including reversal in 19 (59%). Five patients had a second conduit fashioned, two successfully. Conduit type and constipation cause did not significantly influence the rates of ACE reversal or major revision. Ileal conduits were associated with fewer minor revision procedures for stenosis (1 in 7 patients) than appendix conduits (21 in 20 patients). There was one (3%) serious complication. Satisfactory ACE function was ultimately achieved in 47% of patients, at last follow up. After ACE reversal, 9 (28%) patients underwent formation of an end stoma and 3 patients had a colectomy. CONCLUSIONS: Revision procedures are common, but approximately half of patients can expect satisfactory long-term ACE function. ACE conduit reversal does not preclude subsequent alternative surgical strategies to treat this difficult condition.

Adolescent↗
PubMed1995

Caecal impaction in a dog.

A seven-year-old, intact male dobermann with a four-week history of anorexia was diagnosed as having impaction of the caecum with inspissated faeces. Radiographic and histopathological findings revealed impaction of the caecum and a mild subacute locally extensive typhlitis. Typhlectomy was curative and no further problems have been reported.

Animals↗
PubMed1996

Efficacy of metoclopramide for treatment of ileus in horses following small intestinal surgery: 70 cases (1989-1992).

In this retrospective study, postoperative ileus was studied in horses having resection of the small intestine followed by a jejunojejunal (n = 35) or a jejunocaecal (n = 35) anastomosis. Twenty-six horses received no metoclopramide, 27 received metoclopramide as an intermittent intravenous infusion and 17 horses received metoclopramide as a continuous intravenous infusion (0.04 mg/kg/hour). Horses receiving a continuous infusion of metoclopramide had a reduced total volume (P < 0.001), shorter duration (P < 0.001), and a slower rate (P < 0.001) of postoperative gastric reflux, and a shorter postoperative hospital stay (P < 0.01) when compared to horses receiving no metoclopramide and horses receiving metoclopramide as an intermittent infusion. Horses having jejunocaecostomy performed had a larger volume (P < 0.05), longer duration (P < 0.05), and a greater rate (P < 0.05) of postoperative gastric reflux, and a longer postoperative hospital stay (P < 0.001) than horses undergoing jejunojejunostomy. Horses that had an abdominal drain placed during surgery had a longer length of intestine resected (P < 0.05) and a longer postoperative hospital stay (P < 0.05) than horses without an abdominal drain. Horses that died or were euthanased during the postoperative period had a greater total volume (P < 0.05), longer duration (P < 0.05), and greater rate of postoperative gastric reflux (P < 0.01), a longer length of small intestine resected (P < 0.01), and a shorter postoperative hospital stay (P < 0.05) than horses that survived until discharge from the hospital. In a multivariate regression analysis the continuous infusion of metoclopramide was the only variable that contributed significantly to predicting the total volume (P < 0.001; r2 = 0.24), duration (P < 0.001; r2 = 0.24) and rate (P < 0.001; r2 = 0.25) of postoperative gastric reflux. We concluded that metoclopramide given as a continuous intravenous infusion decreased the incidence and severity of ileus following small intestinal resection and anastomosis in horses.

Anastomosis, Surgical↗
PubMedDate not supplied

Effect of intestinal resection on two juvenile horses with granulomatous enteritis.

Two horses were presented with lethargy, weight loss, anorexia, and swelling of the limbs and ventral body wall. One horse, a 12-month-old American Paso Fino colt, also had acute abdominal pain. The other horse, a seven-month-old Tennessee Walking Horse (TWH) filly passed diarrheic stools during the initial examination. Each horse had low serum protein, neutropenia, and a normal packed cell volume (3.2 g/dl, 1300 cells/ul, and 38%, respectively, for the colt, and 2.4 g/dl, 696 cells/ul, and 44%, respectively for the filly). After intravenously administering plasma, the colt's PCV dropped to 23%, and the filly's dropped to 30%. During exploratory surgery, 3.5 and 2.0 meters of thickened terminal small intestine were removed from the colt and filly respectively, and a jejunocecostomy performed. The results of histologic examination of resected intestine were consistent with a diagnosis of equine granulomatous enteritis (EGE). Both horses showed clinical improvement within two days after surgery. The colt developed a neutrophilia (20,500 cells/ul) within 24 hours of surgery. Serum protein concentrations remained stable and gradually elevated to normal or near normal values of 7.0 g/dl (colt) and 5.8 g/dl (filly) by two weeks. The colt was killed four months after surgery because of signs of abdominal pain. Postmortem examination revealed a small intestinal volvulus associated with an adhesion. The TWH filly remains clinically normal 13 months after surgery.

Animals↗
PubMed2000

Effect of extensive ileal resection with a large resulting mesenteric defect and stapled ileal stump in horses with a jejunocaecostomy: a comparison with other anastomotic techniques.

Extensive resection of the ileum of the horse, using automated stapling equipment followed by a stapled jejunocaecostomy, without closure of the mesenteric defect, was evaluated prospectively as a surgical treatment for lesions involving the distal small intestine. Of 153 horses treated surgically for colic, 10 horses with strangulating lesions involving the distal ileum were treated by extensive resection and jejunocaecal anastomosis leaving a residual mesenteric defect. These were compared with 12 horses with jejunoileal lesions treated by jejunocaecal anastomosis with closure of the mesentery, and 19 horses with distal jejunal lesions treated with an end-to-end jejunojejunal anastomosis and mesenteric closure. Long-term (> 7 months) and short-term survival, duration of surgery, length of intestine resected, time from completion of surgery until the horse first defaecated and the highest recorded postoperative plasma fibrinogen level were assessed. There were no significant differences between the surgical techniques for any of the assessed parameters, but there was a trend to significance with a higher death rate following discharge from the hospital when cases of jejunocaecal anastomosis with a residual mesenteric defect were compared to cases of end-to-end jejunojejunal anastomosis with closure of the mesentery (P = 0.06). This study suggests that a stapled distal ileal resection and jejunocaecal anastomosis leaving a residual mesenteric defect is a satisfactory technique when pathological changes necessitate resection of the distal ileum. However, in this study, jejunocaecal anastomosis with or without mesenteric closure produced inferior results compared to jejunojejunal anastomosis.

Anastomosis, Surgical↗
PubMed1990

Stomal adenocarcinoma in Crohn's disease.

Malignant change occurring at the site of a stoma in two patients with proved Crohn's disease is described. Patients with ulcerative colitis have an increased risk of colonic malignancy and Crohn's disease is also associated with both small and large bowel carcinoma. Most previous reports of stomal carcinoma have been associated with ulcerative colitis although Crohn's disease seems to carry a greater risk of associated small bowel carcinomas. This is the first report of stomal carcinoma complicating Crohn's disease. Epithelial dysplasia is associated with gastrointestinal carcinomas in both ulcerative colitis and Crohn's disease and a dysplasia-carcinoma sequence has been suggested as the origin of these tumours. In both our patients with stomal adenocarcinoma, dysplasia was identified in adjacent tissues, which suggests a similar mechanism. Malignant change should be suspected if epithelial dysplasia is discovered in a biopsy specimen from the mucosa of an ileostomy in Crohn's disease, and this risk is increased if the dysplasia is of a high grade.

Adenocarcinoma↗
PubMed2006

Diverting ileostomy set removable without laparotomy--feasibility study.

We constructed an ileostomy set that creates a diverting ileostomy not requiring surgery for closure. The set has two primary components: a double-balloon drainage catheter and a plastic holder. The plastic holder has a rotary component that is used to tighten a percutaneosly placed lasso-loop stitch and purse the enterotomy after the drainage catheter is removed. We tested the ileostomy set in 10 experimental pigs. The drainage catheter was introduced transcecally into the terminal ileum behind Bauhin's valve, and the balloon was inflated. Three to seven days later the drainage catheter was removed, and the cecotomy was closed by percutaneous tightening of the lasso-loop stitch. One week later each animal underwent relaparotomy, and we examined the abdominal cavity for peritonitis. An ileocecal resection was performed, and specimens were collected and evaluated microscopically to ensure that the catheter had not damaged the intestinal wall. The only change noted in the terminal ileum was submucosa lymphatic tissue hyperplasia. No intestinal leaks occurred, and percutaneous enterotomy closure was successful.

Animals↗
PubMed1998

Effects of germinated barley foodstuff in preventing diarrhea and forming normal feces in ceco-colectomized rats.

Germinated barley foodstuff (GBF) derived from the aleurone and scutellum fractions of germinated barley was rich in glutamine and low-lignified hemicellulose. The diarrhea caused by ceco-colectomy could be prevented by feeding GBF to rats. GBF could also increase the protein content and sucrase activity of small intestinal mucosa in this model. This diarrhea-preventive effect of GBF would be based on the water-holding capacity and bulging force under alkaline conditions, e.g. in the small intestine.

Animals↗
PubMed2003

Obstruction of the cecocolic orifice by ileocecocolic intussusception following jejunocecostomy in a horse.

A 4-year-old Thoroughbred stallion was referred for signs of mild to moderate colic, anorexia, and decreased water intake of 3 weeks' duration. Ultrasonographic examination revealed an intussusception, the most common of which would be a cecal inversion or ileocecal intussusception. Surgical exploration identified an ileocecocolic intussusception with extension of the intussusceptum into the right ventral colon; however, the cause of the intussusception could not be identified. The intussusception could not be surgically corrected, and the horse was euthanatized. A side-to-side jejunocecostomy that had been performed previously was identified at necropsy. The ileal stump had intussuscepted into the right ventral colon and become hypertrophied, causing partial obstruction of the cecocolic orifice and clinical signs of colic. In horses requiring an ileocecal or jejunocecal anastomosis, the ileal stump may be left to slough within the cecum as part of the treatment for an irreducible ileocecal intussusception or intentionally inverted into the cecum when the ileal stump is necrotic and cannot be exteriorized and resected. Efforts should be made to minimize the size of the ileal stump to reduce the liklihood of intussusception.

Animals↗
PubMed1988

Colonic reservoirs.

During the last decades several types of surgical techniques have been utilized in order to provide the patient with a continent colostomy using the colon as a reservoir. None of the methods have gained wide acceptance and continence is usually dependent upon successful irrigation. By constructing a cecal reservoir with an intussuscepted nipple valve, using the same principle as for the continent ileostomy, a colostomy with perfect continence for both gas and feces can be created. Although improving life quality significantly when successful, the method is hampered by a high rate of complications and malfunction. So far none of the methods introduced offer any great advantage to conventional sigmoidostomy with irrigation. There is, however, evidence that the functional results after coloanal anastomosis may be improved by constructing a pouch-anal anastomosis. The clinical significance of this technical modification is not yet fully evaluated.

Cecostomy↗
PubMed1954

Caecostomy.

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Cecostomy↗