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At least 847 records · Page 47Linked to original sources
PubMedDate not supplied

Early enteral nutrition after brain injury by percutaneous endoscopic gastrojejunostomy.

Twenty-seven patients in a series of 52 patients with severe brain injury (Glasgow Coma Scale score less than or equal to 8) underwent insertion of intestinal feeding tubes at the bedside. The technique required endoscopy with externalization of gastric and intestinal ports through the abdominal wall. Feedings were begun through the intestinal tube with Vital HN within 4 hours of its insertion with simultaneous gastric decompression via the gastric tube. Tubes were placed 2.3 (range 0-5) days after injury. Full caloric intake (3020 kcal/24 h) was achieved by 6.8 (range 2-8) days after injury to 4.2 (range 2-8) days after placement of the feeding tube. Only 1 patient failed to tolerate feedings immediately after tube insertion. Technical inability to insert the tubes occurred in 3 patients and the intestinal tube migrated into the stomach in 2 patients; diarrhea occurred in only 1 patient. With this technique, it was possible to deliver an average daily intake of 1.2 g/kg of protein in 8-day balance periods beginning at the time of tube insertion. These data included 3- to 4-day periods in which feedings were steadily increased. In 16 patients in whom nitrogen balance was measured for 8-day balance periods, average nitrogen balance was -5.7 (range -11.3 to +3.5) g/24 h. The reduction in nitrogen loss by this technique appears equal to or superior to either gastric feeding or TPN. This technique provides the ability to enterally feed a high proportion of brain-injured patients (except those in barbiturate coma) very early after injury using a bedside procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Radiologic evaluation of gastrostomy complications.

Radiologic examination plays a crucial role in the evaluation of suspected gastrostomy complications. This has not been stressed adequately in the radiologic literature. In a retrospective review of 230 patients who underwent tube gastrostomy for varied clinical conditions, 70 patients who had radiologic examination for evaluation of gastrostomy-related complications were identified. Thirty complications were diagnosed radiologically. There were 11 gastric obstructions, 11 tube displacements, four gastric ulcers, two gastric perforations, one leaking gastrostomy, and one broken gastrostomy tube. Gastric torsion and gastric pneumatosis are reported for the first time as complications of gastrostomy.

Adolescent↗
PubMed2004

[A clinical study using octreotide in relieving gastrointestinal symptoms due to bowel obstruction in a terminally ill cancer patient].

Terminally ill cancer patients with complicated bowel obstructions often have poor quality of life (QOL) due to gastrointestinal symptoms such as nausea and vomiting. Many of these patients are inoperable because of poor general conditions, and half of these patients can't be managed by conventional antiemetics. There are many reports indicating octreotide is effective for these patients. In the present study, 13 patients (5 patients without a nasogastric tube and 8 patients with) were administered octreotide at 300 microg/day by 24 hours continuous subcutaneous infusion. Among the effectively evaluable 10 cases, 6 cases (60.0%) were assessed as effective according to the efficacy criteria based on the JCOG toxicity scale. In the 6 cases who had nasogastric tubes, the nasogastric aspirates decreased from 890 ml (550-1,950) to 480 ml (180-1,790). Vomiting was successfully controlled after the removals of nasogastric tubes in 4 out of 6 cases (66.7%), regarding safety, 2 out of 13 cases (15.4%) showed an excess of liver enzymes but no clinically suspected adverse effect was observed. Octreotide is effective and well tolerated in terminally ill cancer patients with malignant bowel obstruction.

Adult↗
PubMed1991

[Treatment of acute esophago-gastric hemorrhage].

Experience in the treatment of 129 patients with esophagogastric hemorrhage due to portal hypertension is discussed. An original modification of the design of Blakemore's tube is suggested, with the use of which the results of nonoperative treatment were improved and the mortality among this category of patients was reduced. Operation was performed on 75 patients. The total mortality among all hospitalized patients was 6.2%. The Tanner-Petrov operation was carried out on 55 patients, splenorenal anastomosis was formed in 6, organopexy was conducted on 4, splenectomy in combination with organopexy in 8, and portocaval anastomosis was formed in 2 patients. Three patients died after the operation.

Acute Disease↗
PubMedDate not supplied

[Our experience with esophagogastric hemorrhages].

A study was made of 129 cases of upper digestive hemorrhage in patients with portal hypertension admitted at the Surgical Clinic of the Institute of Medicine of Chişinău. About 30% of the patients were late admitted, this delay being due to a misjudgment of patients' state and unawareness of the possibility a new and fatal hemorrhage may occur. A change in Blakemore tube design was done. Its use together with the routine hemostatic therapy resulted in hemostasis and discharge of 42% of the admitted patients. When conservative treatment failed and a recurrence of hemorrhage was imminent, emergency surgery was performed. The Tanner-Petrov surgery, splenorenal anastomosis and various types of organopexy combined with splenectomy proved to be the most successful. General lethality in the patients subjected to these surgeries was 6.2%, a smaller figure than that mentioned in the literature.

Emergencies↗
PubMedDate not supplied

Clinical utility of enteroclysis.

The incidence of pathology in the small bowel is substantially lower than in the upper gastrointestinal tract or colon. This is fortunate since the small bowel, with its unique anatomy and remote location is the most difficult section of the gastrointestinal tract to study. Instillation of contrast into the small bowel lumen can be achieved by the oral route or by the more recently refined technique of small bowel intubation/infusion called enteroclysis. This brief review will focus on the clinical infusion indications for and efficacy of enteroclysis and the relative advantages of enteroclysis over oral methods of small bowel radiography.

Crohn Disease↗
PubMed1990

[General motility disorders of the small bowel].

Gastroenterologists are displaying increasing interest in small-bowel motility disorders. This paper reports on the investigation of motility disorders of the small bowel with a standardized enteroclysis technique with barium and methylcellulose. The method can detect both disturbed motility and morphological changes. Examples of different causes (neurogenic-humoral factors, malabsorption, intestinal wall disease, ischemia and vascular disorders) are described. In some patients the finding of disturbed motility is the only observation of any clinical significance. In others it may be helpful in establishment of correct diagnosis or narrowing of the differential diagnosis. The efficiency and accuracy of small-bowel radiology can be improved by this method.

Barium Sulfate↗
PubMed1989

[Orthograde intestinal irrigation with a mannitol solution in reducing hepatic encephalopathy in patients with liver cirrhosis and gastrointestinal hemorrhage].

The development of hepatic encephalopathy and coma hepaticum in patients with acute gastrointestinal bleeding and hepatic cirrhosis is a serious problem. Since 1983 we perform a whole gut irrigation with mannite for cleansing the bowel via naso-gastric tube. The aim of this therapy is to reduce the severity of hepatic encephalopathy. The first 20 patients with the new therapeutic concept were compared with the last 20 patients with the prevailing therapy. We studied the effect of the new therapeutic concept as to reduction of hepatic encephalopathy and possible electrolyte loss. None of the patients in the mannite group had hepatic encephalopathy stage III or IV, whereas 75% of the patients without mannite showed clinical signs of stage III or IV. Serum potassium, sodium and chloride were not significantly different between both groups. In the group with mannite application no change in serum creatinine was observed, whereas in the other group a minute increase of serum creatinine was seen.

Adult↗
PubMed1989

[Diagnostic strategy in diseases of the small intestine].

For the most frequent and important indications for radiologic examination of the small bowel (passage disorder, blood of unknown origin, inflammatory processes, malabsorption) a diagnostic strategy was established. From the contrast investigations the imaging of the small bowel with a tube, enteroclysma, is preferred. The significance of plain films and sonography is also pointed out. Computed tomography and angiography are rarely indicated. The recommendation of enteroclysma is substantiated by the evaluation of our own series of investigations.

Contrast Media↗
PubMed1972

Clinical uses of an elemental diet: preliminary studies.

Preliminary experience with elemental diet therapy in 30 patients is presented. Positive nitrogen balance and nutritional recovery can be achieved in patients with fistulas, inflammatory bowel disease and pancreatitis, and after extensive resection of the small bowel (short gut syndrome). The mode of administration and rare complications are described.

Adult↗