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At least 973 records · Page 54Linked to original sources
PubMed1995

Prevention of postoperative adhesions by single intraperitoneal medication.

Postoperative adhesions account for a significant morbidity after abdominal, gynecological, or cardiac surgery. A large number of compounds have been suggested to prevent such adhesions, but none is generally accepted. We have compared eight different substances that could be beneficial for the prevention of postoperative adhesions in a new standardized rabbit model with measurement of the areas of adhesion. In 10 groups of 20 rabbits an area of abrasion of the serosa of the ileum, the appendix, and the abdominal wall measuring 10,000 mm2 was created by an emery piston during celiotomy. The controls received no medication. The treatment groups received a single intraperitoneal administration of 1 ml per 100 g body wt of normal saline (NaCl), 5 mg taurolidine (T), 0.5 U plasmin/300 U DNase (PD), 2000 IU streptokinase/500 IU streptodornase (SS), 7 mg phosphatidylcholine (PC), 4 mg hyaluronic acid (HA), 7 mg sphingolipid (SL), 7 mg galactolipid (GL), or 0.5 ml tetrachlorodecaoxide (TCDO), respectively. Ten days later the extent of adhesions was quantified by morphometry. The total area of adhesions (+/- SEM) was found to be 1998 +/- 124 mm2 in controls. The application of NaCl reduced the adhesions to 1368 +/- 58 mm2, of T to 1012 +/- 48 mm2, of PD to 673 +/- 33 mm2, of SS to 360 +/- 44 mm2, of PC to 335 +/- 84 mm2, of HA to 328 +/- 76 mm2, of SL to 278 +/- 80 mm2, of GL to 261 +/- 67 mm2, and of TCDO to 240 +/- 45 mm2. The effects of PD, SS, PC, HA, SL, GL, and TCDO were significant in comparison to controls and NaCl. Our experimental data suggest that the two new lipid substances, SL and GL, are the most likely candidates for routine clinical use in the prevention of postsurgical adhesions.

Abdominal Muscles↗
PubMed2000

Evaluation of sepramesh biosurgical composite in a rabbit hernia repair model.

BACKGROUND: In cases such as incisional hernia repair, polypropylene mesh (PPM) can be exposed to the underlying viscera and cause adhesions to the mesh. In this study, a composite prosthesis that was designed to be less susceptible to adhesion formation than PPM was evaluated in a rabbit incisional hernia repair model. MATERIALS AND METHODS: A 5 x 7-cm full-thickness defect was created in the abdominal wall of 30 female New Zealand White rabbits. Ten animals each were repaired with PPM, Bard Composix (PP/ePTFE), or Sepramesh biosurgical composite-a polypropylene mesh coated on one side with chemically modified sodium hyaluronate and carboxymethylcellulose (HA/CMC). The animals were sacrificed after 28 days and the overall performance, including adhesion formation and tissue integration by histology and mechanical testing, was evaluated. RESULTS: In the Sepramesh group, there was a significant reduction in the percentage of surface area covered by adhesions and a significant increase in the percentage of animals with no adhesions compared to standard materials. The tissue integration strength and overall cellular response were similar in all groups. A partially remesothelialized peritoneal surface was often apparent overlying the Sepramesh implant. CONCLUSIONS: Sepramesh biosurgical composite effectively repaired abdominal wall defects in rabbits and reduced adhesion development to the mesh compared to the use of a PPM and a PP/ePTFE composite.

Absorbable Implants↗
PubMed1993

Cecal volvulus: the CT whirl sign.

Cecal volvulus is a rare, but potentially fatal, cause of intestinal obstruction. As computed tomographic (CT) scanning is often the initial diagnostic test in patients with acute abdominal pain, we reiterate the importance of the "whirl sign" in diagnosing intestinal volvulus. We report the first description of the CT diagnosis of cecal volvulus.

Aged↗
PubMed1992

Incarcerated bariolith of the cecum eight months after a barium meal.

Barioliths consist of inspissated barium mixed with feces. They are a rare complication after barium contrast roentgenography and occur almost exclusively in the large bowel. Mostly asymptomatic or causing only slight symptoms and signs, they may persist for months or years. We report a severe case of cecal bariolith. Clinical symptoms and signs, radiological findings, intraoperative findings, and histology are presented and discussed with reference to the literature.

Aged↗
PubMed1992

A perforated non-specific ulcer of the cecum as seen in a 2-year-old female.

A 2-year-old female was hospitalized because of generalized peritonitis with pneumoperitoneum. A laparotomy disclosed a perforated ulcer of the cecum. A resection of the perforated portion of the cecum was then performed. Histopathologic examinations confirmed that the ulcer was non-specific in nature. No recurrence was observed four years since the limited operation. Pneumoperitoneum caused by perforation of non-specific cecal ulcer in a child has, to our limited knowledge, not yet been previously reported.

Cecal Diseases↗
PubMed1992

Intussusception of an appendiceal mucocele: report of a case.

A 66 year old Japanese female was admitted to our department for the examination and treatment of a mass in the cecum. She had experienced no symptoms or signs other than a positive test result for fecal occult blood. The mass in the cecum was confirmed by barium enema, colonofiberscopy and CT scanning. The presumptive diagnosis was a submucosal tumor of the cecum, however, a laparotomy subsequently revealed intussusception of an appendiceal mass. An ileocaecal resection with an ileocolic anastomosis was therefore performed and the mass was histologically diagnosed as a mucocele of the appendix. This patient is only the 24th case of intussusception of a mucocele of the appendix to be reported in Japan. A review of the available literature on this condition follows the case report.

Aged↗
PubMed1995

Appendiceal intussusception due to an appendiceal malignant polyp--an association in a patient with Peutz-Jeghers syndrome: report of a case.

A 40-year-old woman with Peutz-Jeghers syndrome and an appendiceal intussusception is reported. In this patient, the lead point was a large sessile, appendiceal polyp. The invaginated and inverted portion of the appendix resembled the long stalk of a pedunculated polyp on roentgenography and endoscopic examination. Histologically, the appendiceal polyp was a villous adenoma with mild to severe atypia and focal carcinoma in situ. In patients with Peutz-Jeghers syndrome, hamartomatous polyps and colorectal adenomatous polyps with highly malignant potential can coexist and must be managed appropriately. Therefore, when evaluating a polypoid or a pedunculated lesion in the cecal lumen, the possibility of an appendiceal intussusception should also be investigated.

Adenoma, Villous↗
PubMedDate not supplied

Laparoscopic cecopexy for cecal volvulus. Case report and a review of the literature.

A case of intermittent cecal volvulus in an immunocompromised patient is presented. This patient, whose bowel was viable, was managed successfully by laparoscopic cecopexy. As a clinical entity, cecal volvulus usually presents as either an unrelenting process, culminating in gangrenous bowel, or as an intermittent, recurrent condition with spontaneous resolution but which also may lead to loss of intestinal viability. Surgical management is required in almost every case; however, a review of the literature reveals considerable controversy as to what constitutes the best operation for cases in which the bowel is viable. The most appropriate operation is usually dictated by the clinical circumstances, and in many settings cecopexy is a satisfactory choice of procedure; resection is obviated, bowel need not be opened, and the operation can be performed laparoscopically relatively rapidly.

Acquired Immunodeficiency Syndrome↗
PubMed1975

Hormones and the stimulated sodium transport in cecum hypertrophy.

Sodium transport per unit tissue is stimulated in dietetically produced cecum hypertrophy of the rat. Presumably this reflects an adaptive process. The possibility was tested whether transport adaptation was mediated by hormones, particularly by the pituitary-adrenal system, Cecum hypertrophy was induced by dissolving polyethylene glycol in the drinking water, and cecal sodium and water net absorption was measured in vivo. In both the adapted and normal mucosa, sodium and water absorption per unit macrosurface or dry weight was increased by aldosterone and decreased by adrenalectomy, hypophysectomy and volume expansion while the decrease following adrenalectomy was reversed by cortisol and the absence of antidiuretic hormone in hereditary diabetes insipidus rats had little effect on absorption. However, none of the test conditions abolished the relatively larger absorption of the adapted compared to the normal mucosa. It is concluded that the hormonal effects were additive but not causally related to transport adaptation.

Adrenalectomy↗
PubMed1989

Benign cecal ulcer.

Benign cecal ulceration, generally presenting as a right lower abdominal mass or lower gastrointestinal bleeding in older patients, is often associated with typhoid fever, cytomegalovirus, and ingestion of nonsteroidal anti-inflammatory drugs. Diagnosis is generally made during surgery, but conservative treatment often leads to complete healing. In elective patients, repeated X-ray examinations of the colon, especially with air contrast barium enema and colonoscopy, are recommended to distinguish benign cecal ulceration from a malignancy.

Cecal Diseases↗
PubMed1983

The neuroendocrine system of normal human appendix, ileum and colon, and in neurogenic appendicopathy.

Epithelial endocrine cells containing 5-hydroxytryptamine, substance P, somatostatin, enteroglucagon and vasoactive intestinal polypeptide-immunoreactivity were localized by immunocytochemistry in the mucosa of normal appendices, ileum and proximal colon, and in neurogenic appendicopathy. In neurogenic appendicopathy a large number of proliferating nerves were visualized independently of neurotransmitters by immunostaining for neuron-specific enolase. A large number of nerve fibers were shown to contain substance P-immunoreactivity and to be of intrinsic origin. Stromal endocrine cells containing 5-hydroxytryptamine, somatostatin- and possibly substance P-immunoreactivity, were observed in substantial numbers in neurogenic appendicopathy. Substance P may be involved as a neurotransmitter and/or as a paracrine/endocrine peptide in the pathogenesis of spastic contractions and abnormal peristalsis of the appendix, which are characteristic of neurogenic appendicopathy. Stromal endocrine cells may be considered to be the origin of certain carcinoids in the appendix.

Appendix↗
PubMed1980

Reliability of the abdominal plain film diagnosis in pediatric patients with suspected intussusception.

In order to reassess the diagnostic reliability of the abdominal plain film examination in suspected intussusception, the findings in 100 consecutive cases of this disorder were analysed. Then, these were compared with the same number of cases in which the diagnosis had been rejected by means of barium enema. It was found that a positive plain film diagnosis of intussusception was possible in 89 patients. In 11 cases inconclusive plain film findings called for supplementary barium enemas to establish the diagnosis. In the reference group intussusception was excluded on the basis of plain film findings alone in 74% of cases. In the remaining 26% of patients a barium enema proved necessary to reject the diagnosis of suspected intussusception.

Barium Sulfate↗
PubMed1980

[Neurogenic appendicopathy -- a common disorder, seldom diagnosed (author's transl)].

Over 5000 routine appendix specimens were examined at the Institute for Pathological Anatomy, Graz University, for the presence of neurogenic appendicopathy (n.a.). With light microscopy it was possible to differentiate intramucosal, finely vacuolated nerve proliferations and central neuromas (n.a. in the narrower sense), as well as neuromuscular proliferations in the submucosa. All three forms are considerably more common in females. A diagnosis of neurogenic appendicopathy was made in 17.9% of all cases. The disorder is uncommon in the first decade of life, more common in the second decade, and, after the age of 45, is diagnosed histologically in a scant half of the cases. Clinically, n.a. cannot be distinguished with certainty from purulent or chronic recurrent appendicitis; leukocytosis and fever are also not sure criteria for a differential diagnosis. N.a. in the narrower sense is frequently accompanied by vegetative symptoms (variable blood pressure, constipation and diarrhea, meteorism, sweating). These symptoms are probably caused by hormones produced by the endocrine cells which are present in abnormally large quantities in the epithelial tissue and especially in the mucous stroma. As neurogenic appendicopathy can, at present, be diagnosed only histologically, it is to be encouraged that all such material, even when macroscopically unremarkable, be so examined.

Adolescent↗