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PubMedDate not supplied

Acute intestinal obstruction as an initial presentation in Crohn's carcinoma.

A 40 years old female patient presenting with symptoms of acute intestinal obstruction was diagnosed as a case of adenocarcinoma superimposed on Crohn's disease. The diagnosis, as happens in most of these cases, was established post-operatively on the basis of histopathological examination. Acute intestinal obstruction due to adenocarcinoma in Crohn's disease as an initial presentation is very uncommon especially in this geographical area where Crohn's disease in itself is an uncommon disease entity.

Adenocarcinoma↗
PubMed1989

[Intestinal obstruction in extensive postoperative ventral hernia].

The work is based on an experience with surgical treatment of 1017 patients. Intermittent intestinal obstruction was observed in more than 40% of them and was not always dependent on the character of commissural processes. The most frequent cause of its appearance is a combination of commissures with a considerable ptosis and formation of flexions, angular deformities and incomplete torsion of intestinal loops. Supermedial and subcostal hernias with most pronounced commissural processes are comparatively rarely followed by intestinal obstructions (12.5%). It was more often observed in middle- and inferior-medial (56.1%) and iliac (33.3%) hernias with less spreaded commissures.

Abdomen, Acute↗
PubMed1991

[Intraoperative intubation of the small intestine in surgery of mechanical intestinal obstruction. Experience with a method of intraoperative and postoperative maintenance in mechanical obstruction using a long multi-pierced tube applied intraoperatively].

The Authors describe their experience from 1986 to 1990 of intraoperative intubation of the small intestine to obtain intra- and post-operative decompression of intestinal loops and for prevention or postoperative adhesions in intestinal obstruction case. Two methods are reported; one using the ready-made long intestinal "Baker" tube, and another consisting of using a self-made tube with available materials. Enumeration of cases is reported, and the lack of complications from the use of the method is stressed. The good result in the prognosis of obstructive intestinal disease is also stressed.

Adult↗
PubMed1979

[Intestinal obstruction with feces (meconium ileus equivalent) in the course of mucoviscidosis. Radiographic diagnosis (author's transl].

Meconium ileus equivalent is a late intestinal occlusion occurring in patients suffering from mucoviscidosis. Three cases are reported in children aged, respectively, 3 years, 6 years and 10 years. In one of the observations (three year old girl), the intestinal obstruction with feces was first manifestation of a mucoviscidosis that was previously undetected. The radiological signs are identical to those found in cases of neonatal meconium ileus: intestinal obstruction and accumulation of closely spaced matter in a distended ileum (terminal part). As in cases of meconium ileus without complications, treatment consisted of enemas with water-soluble products. The high osmotic pressure of these products made it possible to remove the obstruction.

Child↗
PubMed1976

[Intestinal obstruction in children caused by congenital adhesions and fibrous cords].

The authors present an analysis of 36 observations of congenital adhesive intestinal obstruction in children aged from 1 day to 11 years. In newborn infants and small children, aged from 1 to 3 years, the disease was mostly manifested in the clinic of acute obstruction. Therefore, all these children were operated upon on urgent indications. An importance of restoration of the bowel function as early as possible is emphasized for prophylaxis of the adhesive process. Postoperatively, physical therapy and prolonged peridural anesthesia are widely advocated. No recurrence of adhesive intestinal obstruction was noted.

Child↗
PubMed1998

Small bowel volvulus: a common cause of mechanical intestinal obstruction in our region.

OBJECTIVE: To find out the incidence and causes of small bowel volvulus in our region, and to analyse the results of our management. DESIGN: Retrospective study. SETTING: Teaching hospital, Turkey. SUBJECTS: 38 Patients who had had no previous abdominal operations who were operated on for mechanical intestinal obstruction caused by small bowel volvulus. MAIN OUTCOME MEASURES: Incidence of small bowel volvulus, details of patients, treatments, complications, and outcome. RESULTS: Small bowel volvulus constituted 8%(38/466) of all cases of mechanical intestinal obstruction and 13%(38/292) of small bowel obstruction. Volvulus was primary in 18 (47%), and secondary in 20 (53%) patients. 33 Patients (87%) were male. The mean age of the whole group was 30 years, 42 and 19 in patients with primary and secondary volvulus, respectively (p=0.0005). The incidence of small bowel volvulus was 19%(27/143) in patients under 40 years, and 7%(11/149) in those over 40 years of age (p=0.005). Sixty percent of patients with secondary volvulus (12/20) were under 20 years of age compared with 17% of those with primary volvulus (3/18; p=0.009). The causes of secondary volvulus were Meckel's diverticulum in 14 patients (70%), and malrotation and ileosigmoid knotting in 3 patients each (15%). Segments of bowel were gangrenous in 12 patients (32%). Treatment was by simple untwisting in patients with viable segments of gut, or with resection of gangrenous segments and primary small bowel anastomosis. One patient died postoperatively of septic shock. CONCLUSIONS: Small bowel volvulus is a common form of intestinal obstruction in our region. It carries a high risk of gangrene of twisted segments of bowel. Fortunately perforation of small bowel is uncommon, and resection and primary anastomosis is a safe procedure in cases of necrosis. Today the outcome of such patients is satisfactory. Early and proper management is essential for a good outcome.

Adolescent↗
PubMed2001

[Intestinal obstruction in cancer patients: results of palliative surgery].

OBJECTIVE: The study aim was to investigate predictive factors related to the results, in terms of survival and quality of life, of palliative surgery in cancer patients presenting with intestinal obstruction. METHODS: A total of 109 patients already treated for a neoplasm were operated on for intestinal obstruction between 1990 and 2000. The investigated prognostic factors were age, sex, location of the primary tumour, extension of the cancer at the time of the operation and the surgical procedure carried out. The impact on the quality of life was assessed by the resumption of intestinal transit and the return home. RESULTS: The median survival rate was 64 days and the postoperative mortality rate 21%. The quality of life was improved in 65% of the patients. The only factors clearly correlated with survival and the success of the operation were the aetiological diagnosis of the intestinal obstruction and the type of procedure which was possible to carry out. CONCLUSION: Palliative surgery may improve the quality of life of a certain number of patients, but it was not possible to demonstrate predictive factors for the selection of patients who could have the larger benefits of such surgery.

Adult↗
PubMed2004

Fetal intestinal obstruction induces alteration of enteric nervous system development in human intestinal atresia.

Intestinal motility disorders are a major cause of morbidity after surgical repair of intestinal atresia of unknown mechanism. We hypothesized that interruption of antenatal peristalsis may disturb the normal development of the enteric nervous system. Using a series of neuronal (synaptophysin, neuronal nitric oxide synthase, neurofilaments) and nonneuronal markers (glial acidic fibrillary protein and c-Kit) and immunohistochemistry, we have defined developmental steps of the enteric nervous system in normal intestine (12 fetuses, 15 children, and 4 adults) and their alterations above and below the obstacle in 22 human intestinal atresia compared with age-matched controls. Antisynaptophysin antibody revealed the progressive conversion of the myenteric plexus from a continuous belt into regularly spaced ganglions during normal fetal gut development and, by contrast, the significantly delayed appearance of individual neuronal ganglions in the distal segments of atresia (p < 0.05). Staging using three other markers for neuronal (neurofilaments and neuronal nitric oxide synthase) and nonneuronal cells (glial acidic fibrillary protein) confirmed that maturation of the myenteric plexus was significantly delayed below atresia (p < 0.01). These results indicate that intestinal atresia impairs the development of the enteric nervous system and provide an anatomical substrate for the motility disorders observed after surgical repair. They point to the role of peristalsis in normal gut development and suggest that stimulation of peristalsis might be used to accelerate recovery.

Biomarkers↗
PubMed1994

[Diagnosis and surgical techniques in adhesive intestinal obstruction].

The work analyses the results of examination and treatment of 273 patients, aged from 18 to 74 years, with ileus caused by adhesions (AI). There were 159 males and 113 females. The diagnosis of AI was based on the findings of clinicoradiological, ultrasonic, and endoscopic examination. Early AI was recognized in 61 and delayed AI in 212 patients. Nonoperative therapy was effective in 53 patients. Operation was performed on 220 patients. Twenty-one patients underwent emergency operations due to peritonitis, urgent surgery was performed in 163 patients with unsuccessful complex nonoperative treatment and growth of clinical manifestations of AI, 36 patients were managed by planned operations after adequate examination and preoperative treatment. Obstruction of the small intestine was found in all patients: dynamic in 60, strangulation in 111, obturation in 66, and recurrent in 36 patients. Cutting of the adhesions was the operation of choice, it was performed in 178 patients. Nobles' intestinoplication was conducted in 24 and resection of the small intestine in 15 patients. A bypass anastomosis was formed in 3 patients. Postoperative complications occurred in 18 patients, 10 had to be reoperated on. Twenty-one (9.5%) patients died after surgery; 8 after emergency operations and 13 patients after urgent operations. Death was caused by intoxication (7), peritonitis consequent upon failure of the anastomosis sutures (5) hepatic failure (3), acute cardiovascular failure (3), thromboembolism of the pulmonary artery (2), and stroke (1).

Adolescent↗
PubMed1980

Paralysis of the small bowel resembling mechanical intestinal obstruction.

In some instances, particularly in the neonate, paralytic ileus affects predominantly the small bowel, thus resembling intestinal obstruction. Localized paralysis of the small bowel occurs secondary to regional events in a segment of gut and resembles mechanical obstruction even more closely. In localized paralysis the bowel lumen is usually dilated without abrupt distal transition to collapsed intestines. If there is radiographic and clinical recognition of localized, transitory bowel paralysis, surgery is usually unnecessary.

Adolescent↗
PubMed2003

Meckel's diverticulum and intestinal obstruction--report of a fatal case.

Meckel's diverticulum is an uncommon cause of intestinal obstruction in adult life. Rarely Meckel's diverticulum is complicated by a mesodiverticular band, which is believed to be a remnant of a vitelline artery. When this abnormality occurs it is associated with high mortality. We present a case of a 48-year-old man with increasing abdominal pain and vomiting for 3 days. Meckel's diverticulum was not taken into diagnostic consideration, and the man died. Autopsy revealed a Meckel's diverticulum with a mesodiverticular band and intestinal obstruction. Histological examination of cross sections of the mesodiverticular band showed the presence of an artery. Because of the high mortality of this rare anatomic anomaly in adults, we find the case of interest.

Abdominal Pain↗
PubMed1990

[The role of hemosorption in preventing and treating pulmonary disorders in patients with peritonitis and acute intestinal obstruction].

An analysis of treatment and examination of 80 patients with peritonitis and acute intestinal obstruction of different etiology has been made when hemosorption was used for struggle against intoxication. It has been shown that hemosorption possessing a potent detoxicating effect considerably facilitates activation of the non-gas-exchange functions of the lungs. However, losses of the surfactant synthesis components during hemocarboperfusion as well as absorption of oxygen by certain sorts of charcoal (SKN-4M, SKN-1K) results in arterial hypoxemia. For prophylactics and treatment of pulmonary disorders in patients with peritonitis and acute intestinal obstruction hemosorption must be supplemented with repeated sessions of spontaneous respiration with positive pressure at the end of breathing out.

Acute Disease↗