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At least 721 records · Page 40Linked to original sources
PubMed1964

RADIATION ENTEROPATHY OF THE SMALL BOWEL.

The features of radiation injury of the small bowel are reviewed to focus attention on this uncommon but persistent problem which usually arises in women undergoing treatment for gynecological malignancy and which may be confused with recurrence of the malignant growth. Intestinal perforation, bleeding, obstruction and fistulas have all been observed in patients with radiation enteropathy. Three cases in which these complications occurred are reported. Early excisional surgery is considered to be the preferred treatment, although conservative surgical procedures have been used for patients who are very ill or for those with diffuse bowel changes. Medical measures alone have not been successful but have been utilized in preoperative preparation.

Female↗
PubMed2003

[A Turkish man with Behçet disease and recurrent acute abdomen].

Following a total hip prosthesis, a 52-year-old Turkish man with Behçet's disease developed persistent ileus due to intestinal perforations. Resection of the intestine was followed by new perforations, resulting in resection of another portion of the intestine and the start of immunosuppressive medication. Following the 5th resection for a perforated ulcer in the space of two weeks, an ileostomy was performed. One year later the stoma could be eliminated and the patient remained symptom-free. Behçet's disease is relatively rare in the Netherlands. However, the gastrointestinal complications may be life-threatening. Surgical intervention is then often necessary. Complications and recurrences are frequent.

Abdomen, Acute↗
PubMed1998

Spontaneous gastrointestinal perforation in very-low-birth-weight infants--a rare complication in a neonatal intensive care unit.

Over a 6-year period (1989-1995), gastrointestinal (GI) perforation was diagnosed in nine preterm infants (mean gestational age 27 weeks, mean birth weight 872 g). Three presented with necrotizing enterocolitis (NEC), two with indwelling-tube-induced perforation of the stomach, one with small-left-colon syndrome, and another with meconium ileus. Spontaneous intestinal perforation occurred in two similar very-low-birth-weight (VLBW) infants, in the distal ileum, on days 8 and 9 of life, respectively. The only clinical sign was extensive abdominal distension, and abdominal X-ray studies revealed free peritoneal air. All findings were distinct from those associated with NEC. Their further clinical course was complicated by reperforation on day 32 and 39, respectively. They subsequently recovered and presented without GI problems at the corrected ages of 4 and 2 months, respectively. In contrast to high mortality of 57% in the group with non-spontaneous intestinal perforations, spontaneous perforation seems to have a good prognosis even in VLBW infants if diagnosed and treated promptly.

Female↗
PubMed1989

[Clinical study of allergic granulomatous angitis (AGA) with accompanying gastrointestinal perforations--our case and other cases in Japanese literature].

We present here the case of a patient with allergic granulomatous angitis (AGA) who had two small intestine perforations in a short interval, and we reviewed 11 cases, including our own, of AGA with accompanying gastrointestinal perforations reported so far in Japan. Our case was a twenty-three year old man who had been treated with steroid hormone in an outpatient clinic. He re-entered our hospital complaining of severe abdominal pain. At first admission, there had been no evidence of parasite disease, and this time, we found severe duodenal erosion on upper gastrointestinal endoscopy. Abdominal angiography revealed stenotic and tapering changes probably due to angitis in both the superior and inferior mesenteric arteries. Steroid pulse therapy was not effective in reducing the severity of abdominal pain, but the administration of a large amount of PGE1 was very effective. In spite of the therapy, the patient had small intestine perforations on his 27th day in hospital and two months thereafter, and was operated on twice. The death rate in AGA patients with accompanying gastrointestinal perforations is relatively high in our country, and 2 out of 11 cases had recurrent perforations. Therefore, it is considered essential to pay great attention to abdominal manifestations in AGA patients.

Adult↗
PubMed1988

Tuberculous enteritis and peritonitis.

In Turkey, diseases associated with Mycobacterium tuberculosis are common. Intestinal tuberculosis has generally been a complication of pulmonary tuberculosis, but recently there has been an increase in the frequency of intestinal tuberculosis without the pulmonary form. The authors present their experience over 8 years in 41 patients (aged 15 to 56 years) who underwent surgery for tuberculous enteritis (14), peritonitis (13), a combination of the two (5), genital tuberculosis and peritonitis (5) and tuberculous mesenteric lymphadenitis (4). Of these, 29 had no associated pulmonary tuberculosis. Eighteen of the 41 patients had complications of their disease-bowel obstruction in 13, intestinal perforation in 2, intestinal bleeding in 2 and enterocutaneous fistula in 1. The diagnosis was established at operation and by the appearance of caseating granuloma on histologic examination and isolation of the causative organism. Twenty-four patients required emergency surgery; 2 who had bowel perforation died. Operative procedures included laparotomy with biopsy (17), resection of intestine (10), division of adhesions (7), evacuation of mesenteric abscesses (4) and bypass (3). There were seven (17%) operative deaths. The authors recommend that noninvasive procedures be used for the diagnosis of intestinal tuberculosis, but if these fail, surgery is indicated.

Adolescent↗
PubMed1986

Ileal perforation due to cytomegaloviral enteritis.

As the AIDS epidemic unfolds, many newly described clinical syndromes resulting from unusual manifestations of opportunistic infections are being seen. The authors report the clinical and pathological features of intestinal perforation in an AIDS patient caused by extensive small-bowel ulcerations due to cytomegalovirus. The diagnosis was confirmed by ultrastructural and immunohistochemical studies. It is suggested that infection and destruction of the muscularis propria by the virus contributes to intestinal perforation.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Rectal extrusion of the catheter and air ventriculography following bowel perforation in ventriculo-peritoneal shunt.

Ventriculo-peritoneal shunt is frequently carried out in infantile hydrocephalus. The peritoneal shunt has a lower morbidity than ventriculo-atrial shunts and severe complications are uncommon. Abdominal complications include intestinal perforation, shunt migration, inguinal hernia, cerebrospinal fluid pseudocysts and hollow viscus perforation. A few cases of catheter extrusion from the rectum, vagina, umbilicus and urethra have been described. We report a new case of intestinal perforation with rectal extrusion of the catheter associated with a ventriculogram.

Cerebrospinal Fluid Shunts↗
PubMed1988

Gastrointestinal perforations in the neonatal period.

Forty-eight neonates were treated for gastrointestinal perforation during a 9-year period. In 30, perforation occurred within the first week of life. Thirty-six were preterm infants and many had a history of obstetric and postnatal complications. Perforation resulted from necrotizing enterocolitis in 26 patients, whereas in 14 neonates spontaneous perforation occurred in an apparently normal bowel, with no evident cause (idiopathic perforation). In 6 patients perforation was associated with meconium ileus. Primary closure was carried out for perforations of the duodenum and stomach. Intestinal perforations were usually treated by resection and enterostomies. The overall mortality rate in this series was 46%. The highest mortality rate was associated with necrotizing enterocolitis (62%). The mortality rate was only 14% in patients with idiopathic perforation. Despite improvement in the prognosis of neonatal gastrointestinal perforations in recent years, it is still discouraging, reflecting the difficulty in preventing and treating necrotizing enterocolitis.

Enterocolitis, Pseudomembranous↗
PubMed1992

[Idiopathic perforation of the colon with simultaneous acute appendicitis in a newborn. Presentation of a case].

We report a case of a three days old male newborn who suffered several apnea crisis. Radiologic studies revealed a pneumoperitoneum. Laparotomy proved it was caused by two intestinal perforations in the ascending colon. Histologic study showed a concomitant suppurated acute appendicitis. We discuss the case features, its possible etiopathogeny and the most frequent clinical aspects and treatment of intestinal perforation at this age.

Acute Disease↗
PubMed1994

[Jejunal perforation as initial metastatic manifestation of laryngeal carcinoma].

A case of acute abdominal pain due to jejunal perforation in a patient with dissemination of laryngeal carcinoma is presented. Six jejunal intramural nodes of squamous cell carcinoma, one of them perforated, were observed at laparotomy. At the same time, a lesion suspicious of local recurrence in the tracheostomy orifice was observed. The patient died in the postoperative period. The rarity of intestinal perforation as an initial manifestation of metastatical dissemination of a laryngeal squamous cell carcinoma as well as its poor prognosis are discussed. The hematogenous spread is proposed in our case. Finally the inclusion of metastases in the differential diagnosis in a clinical episode of intestinal perforation in patients with a history of neoplasm is emphasized.

Aged↗
PubMed1996

Is computed tomography a useful adjunct to the clinical examination for the diagnosis of pediatric gastrointestinal perforation from blunt abdominal trauma in children?

Perforations of the gastrointestinal (GI) tract, compared to solid organ injuries, are a relatively infrequent sequela of blunt abdominal trauma in children. The purpose of this study is to review retrospectively the diagnostic modalities used in 30 children with proven traumatic intestinal perforations treated at one institution. Since computed tomography with intravenous and oral GI contrast is commonly used in the diagnosis of suspected solid organ injury from blunt abdominal trauma, we evaluated retrospectively the computed tomographic (CT) scan findings in these children in an attempt to accurately predict or suggest GI perforation. Between January 1987 and December 1993, 5,795 children were admitted. Three hundred fifty suffered blunt abdominal trauma of which 30 patients (8.5%) required surgery for a GI perforation and formed the basis for this study. Data collected were mechanisms of injury, results of admission and serial clinical examinations, results of radiologic imaging, associated injuries, operative findings, and outcome. Follow-up was obtained on all patients and averaged 2.5 years. Blows to the abdomen (handlebars, cars, kicks) were the most common cause of perforation, followed by seatbelt injuries. Eleven patients underwent immediate laparotomy an average of 0.75 hours after admission. The indication for surgery was shock (three), clinically apparent peritonitis (five), and free air on plain abdominal radiograph (three). Nineteen patients underwent "later" laparotomy, an average of 3.4 hours after admission, all because of the eventual development of peritonitis. Retrospective review of these CT scans revealed free air anterior to the liver in three, and the remaining 16 had CT findings suggestive of GI injury such as free fluid, focal fluid-filled thick-walled bowel loops, and mesenteric infiltration. There were five (26%) false negative CT scans performed an average of 5.0 hours after injury. We believe serial physical examinations are the gold standard for diagnosing pediatric GI perforation from blunt abdominal trauma. The CT scan may be a useful adjunct to the diagnosis of an intestinal perforation in patients who have no immediate indication for surgery. Presently, the only CT finding that is an absolute indication for laparotomy is free air (in the absence of pulmonary/mediastinal injury or barotrauma). The other CT "findings" need to be validated prospectively.

Abdominal Injuries↗
PubMed2003

[Diarrhea after vascular reconstruction of an abdominal aortic aneurysm].

HISTORY AND CLINICAL FINDINGS: A 60-year-old man had a dacron aortofemoral bypass graft inserted to replace a ruptured infrarenal aortic aneurysm rupture. He subsequently had tachyarrhythmic atrial fibrillation with heart failure, NYHA class IV, and diffuse abdominal pain associated with watery diarrhea. INVESTIGATIONS: Stool tests merely demonstrated Candida albicans. Abdominal ultrasound revealed intestinal loops with thickened walls and decreased peristalsis. Coloscopy demonstrated a retroperitoneal intestinal perforation with abscess formation resulting from ulcerative necrotizing rectosigmoid colitis which had also uncovered the vascular prosthesis near the abscess cavity. DIAGNOSIS: Ischemic transmural necrotizing rectosigmoiditis with retroperitoneal intestinal perforation. TREATMENT AND COURSE: The rectosigmoid colon was resected and an end-colostomy made with closure of the rectal stump (Hartmann's operation). The uncovered right limb of the vascular graft was covered completely and was discharged, being now mobile using a walking frame. There was no evidence of infection in the dacron prosthesis. CONCLUSION: A transmural progression of an ischemic colitis should be considered as a late sequela after emergency vascular reconstruction of the abdominal aorta. Even if symptoms are mild, early postoperative sigmoidoscopy is indicated.

Aneurysm, Ruptured↗
PubMed2006

Tension pneumothorax secondary to colonic perforation during diagnostic colonoscopy: report of a case.

We report a case of tension pneumothorax, which occurred secondary to colonic perforation during a colonoscopy. The patient was a 77-year-old woman in whom acute respiratory decompensation developed suddenly during a diagnostic colonoscopy for iron deficiency anemia. We diagnosed bilateral pneumothoraces, tension pneumothorax, pneumomediastinum, pneumoperitoneum, and emphysema of the face, neck, and chest. At laparotomy, a posterior colonic perforation was identified at the site of an ileocolic anastomosis performed 3 years earlier. We performed a primary repair and the patient was discharged from hospital 12 days later. Although diagnostic colonoscopy-induced intestinal perforation is rare, it is the most common and serious complication associated with this procedure. Occasionally, air spreads from the retroperitoneum into continuous tissue planes and decompresses into the adjacent structures. To our knowledge, this is the first report of two unique manifestations of diagnostic colonoscopy-induced intestinal perforation: tension pneumothorax and perforation at the site of a previous anastomosis. Both of these conditions should be considered in the event of acute respiratory failure in the endoscopy suite.

Aged↗