Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “INTESTINAL PERFORATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,045 records · Page 58Linked to original sources
PubMedDate not supplied

[Peritoneal complications during continuous ambulatory peritoneal dialysis: surgical aspects].

The principal complication of continuous ambulatory peritoneal dialysis (CAPD) is peritonitis in most cases benign and treated effectively by local, specific antibiotic therapy. In some cases, however, the infection fails to respond to medical treatment and surgical exploration occasionally reveals serious lesions such as sclerosing peritonitis or an intestinal perforation. Prognosis is dependent not only on the extent and severity of the lesion but also on the rapidity of operative intervention. The development of an appendicitis, often masked by early antibiotic therapy, represents a particular course of peritoneal infection during CAPD.

Adolescent↗
PubMed2006

Prevention of necrotizing enterocolitis in preterm infants: a 20-year experience.

OBJECTIVE: Diet, indomethacin, and early use of dexamethasone have been implicated as possible causes of necrotizing enterocolitis and intestinal perforation. Because we seldom prescribe indomethacin or early dexamethasone therapy and we follow a special dietary regimen that provides late-onset, slow, continuous drip enteral feeding, we reviewed our 20 years of experience for the incidence of necrotizing enterocolitis and bowel perforation. METHODS: We reviewed data on all 1239 very low birth weight infants (501-1500 g) admitted to our level III unit over a period of 20 years (1986-2005), for morphologic parameters, necrotizing enterocolitis, bowel perforation, use of the late-onset, slow, continuous drip protocol, and indomethacin therapy. Outcome data were also compared with Vermont Oxford Network data for the last 4 years. RESULTS: In 20 years, 1158 infants received the late-onset, slow, continuous drip feeding protocol (group I), whereas 81 infants had either a change in dietary regimen, use of indomethacin, or early use of dexamethasone (group II). The rate of necrotizing enterocolitis in group I of 0.4% was significantly lower than that in group II of 6%. Group I, in comparison with the Vermont Oxford Network, had significantly lower rates of necrotizing enterocolitis (0.4% vs 5.9%), surgical necrotizing enterocolitis (0.4% vs 3.1%), and bowel perforation (0.35% vs 2.2%). CONCLUSIONS: Our 20-year experience with 1239 very low birth weight infants suggests strongly that the late-onset, slow, continuous drip feeding protocol and avoidance of indomethacin and early dexamethasone treatment contribute to the prevention of necrotizing enterocolitis.

Dexamethasone↗
PubMed2001

Unexpected childhood death due to a rare complication of ventriculoperitoneal shunting.

A 10-year-old boy with Arnold-Chiari malformation, spina bifida, and a ventriculoperitoneal shunt for hydrocephalus died unexpectedly, having appeared to be only mildly unwell with fever on the night before death. At autopsy, the shunt was partially obstructed with an associated enterococcal meningitis. The tip of the shunt was located within the transverse colon, which was embedded in a mass of fibrous adhesions resulting from previous abdominal surgery. Blood cultures were sterile. Intestinal perforation is a rare complication of ventriculoperitoneal shunting that may be associated with the development of meningitis and unexpected death. The autopsy assessment of children with such indwelling devices requires examination of the functional state of the shunt, full septic workup, and determination of the precise location of the tip of the catheter within the peritoneal cavity.

Arnold-Chiari Malformation↗
PubMed1993

Prospective comparison of diagnostic peritoneal lavage, computed tomographic scanning, and ultrasonography for the diagnosis of blunt abdominal trauma.

From January through December 1990, a prospective study comparing the accuracy of diagnostic peritoneal lavage (DPL), abdominal computed tomographic (CT) scanning, and abdominal ultrasonographic (US) scanning was carried out. Patients with stable vital signs following their initial resuscitation coupled with equivocal physical examination findings received both CT and US scanning. A DPL was then done. If any of these three examinations produced positive findings, a laparotomy was done and the surgical findings were compared with the results of the diagnostic studies. Fifty-five patients were studied (44 men, 11 women), with a mean age of 43 years and a mean ISS of 18.5 +/- 10.5. The sensitivity, specificity, and accuracy were 100%, 84.2%, and 94.5% for DPL, 97.2%, 94.7%, and 96.4% for CT scanning, and 91.7%, 94.7%, and 92.7% for US scanning. Problems do exist in identifying isolated small intestinal perforations with ultrasonography. Since more and more trauma centers are using ultrasonography in the emergency department as a screening method in the management of patients with blunt abdominal trauma, it is important to avoid overestimating its capability. Frequent re-evaluation of the patient's condition, repeat ultrasonographic scans, diagnostic peritoneal lavage, and CT scanning are complementary and important in the diagnosis of blunt abdominal trauma.

Abdominal Injuries↗
PubMed1989

[Severe Epstein-Barr virus infection in an infant].

A 11 month-old boy, without any informative familial pedigree, was admitted for peritonitis after intestinal perforation, associated with signs of pseudolymphoma and histiocytic activation. He developed later unexplained gastrointestinal bleeding and interstitial pneumonitis, which spontaneously improved. All infectious and immunologic studies were negative. Epstein-Barr Virus was found in throat, lungs and blood, whereas the specific antibodies production was delayed. No abnormality was detected 18 months later, except for a disappearance of vaccinal antibodies.

Humans↗
PubMed1983

Traveling toothpicks.

Although most ingested foreign bodies usually pass through the gastrointestinal tract uneventfully, such objects infrequently cause intestinal perforation and may even result in death. Herein we present five cases of gastrointestinal perforation caused by toothpicks. In one of these patients, the toothpick penetrated the inferior vena cava and caused overwhelming bacteremia and death. A major factor that contributes to the inability to identify foreign objects such as toothpicks in food is the wearing of dental plates, which precludes normal palatal sensitivity. Patients should be alerted to the potential hazards associated with the use of toothpicks.

Adult↗
PubMed1997

Malignant lymphoma originating in the jejunum of a long-term follow-up case of protein-losing enteropathy.

A 50-year-old female patient, who had been followed for 15 years for protein-losing enteropathy, was hospitalized due to epigastric pain. Examination on admission revealed that the patient was in the sub-ileus state. On the 26th day after admission, she complained of severe abdominal pain and shortly after she went into shock. The emergency laparotomy documented intestinal perforation and a tumor. The perforated site was right at the middle of tumor. The histological and histochemical studies identified the tumor as malignant lymphoma of B lymphocyte lineage. As far as we know, this is the third case of malignant lymphoma occurring in the jejunum in a patient with protein-losing enteropathy in Japan. The possible relationship between lymphomas and protein-losing enteropathy is discussed.

Female↗
PubMed1997

Effect of oral contrast administration for abdominal computed tomography in the evaluation of acute blunt trauma.

STUDY OBJECTIVE: To determine how frequently oral contrast medium (OC) is essential for computed tomography (CT) diagnosis of blunt intraabdominal injury and to quantify the delay associated with OC administration and the incidence of adverse effects. METHODS: This retrospective chart review, with prospective reevaluation of CT scans for diagnostic value of OC, took place in a university teaching hospital and Level l trauma center. Participants were blunt-trauma victims admitted between June 1, 1988, and November 1, 1993, who had abdominal CT as part of their initial evaluation. Trauma registry records were used to identify study patients. Available charts and CTs were reviewed for all patients with intestinal/mesenteric and pancreatic injuries. Randomly selected cases of liver injury, spleen injury, and no intraabdominal injury were also reviewed. Blinded CT scans were reevaluated for quality of bowel opacification and value of OC to diagnostic impression. RESULTS: During the study period, 2,162 blunt-trauma patients had an abdominal CT; 297 intraabdominal injuries were diagnosed in 248 patients. Full review was done on 124 charts, and 70 CT scans were reevaluated. Thirty-one (100%) of 31 liver and spleen injuries were diagnosed on CT, and OC was considered essential in none of these studies. One (4.5%) of 22 intestinal and mesenteric injuries was seen on CT, but this was the only such injury treated nonoperatively. None of 21 surgically confirmed intestinal/mesenteric injuries was seen on CT. Free air or free OC was seen in none of 7 cases of intestinal perforation. OC was judged essential in none of 20 scans in patients without intraabdominal injury. On 2 scans. OC was considered essential for the radiographic diagnosis. One of these was a normal pancreas at exploration (radiographic false-positive result). The only pancreatic injury requiring specific surgical treatment was missed on CT. Twenty-one percent of patients required placement of nasogastric tube for contrast administration after failing oral administration, and 23% vomited OC. One of 124 had documented aspiration of OC. Average additional time incurred in the ED for administration of OC was 144 minutes. CONCLUSION: OC is rarely essential for CT diagnosis of intraabdominal injury. It may improve sensitivity for pancreatic injury, but it does not help identify injuries requiring surgical treatment. Even with OC, CT is insensitive for intestinal injury. Vomiting and aspiration are significant risks. Use of OC adds a significant amount of time to ED evaluation. Adverse effects of OC administration, in this setting, may outweigh its benefits.

Abdominal Injuries↗
PubMed2003

Tissue plasminogen activator for the treatment of intraabdominal abscesses in a neonate.

Fibrinolytic agents have been used successfully in the management of loculated empyema; however, their use in the treatment of intraabdominal abscesses is limited. The authors describe the case of a 4-week-old girl with intraabdominal abscesses secondary to intestinal perforation that were not amenable to percutaneous drainage, but were managed successfully with intracavitary administration of tissue-plasminogen activator. This case represents the first report in a human, in which tissue-plasminogen activator was used to facilitate percutaneous drainage of an intraabdominal abscess. It is also the first time a fibrinolytic agent has been used for this purpose in a child.

Abdominal Abscess↗
PubMed2004

[A case of gastric mucosal bridge with Behçet's disease].

A 69-year-old man visiting our hospital with an epigastralgia and tarry stool was diagnosed as having Behçet's disease on the basis of repetitious aphthous stomatitis, erythema nodosum and arthralgia in 1991. The next year, he suffered from double active ulcers in the antrum of the stomach, and he had been operated on for intestinal perforation. In 1994, endoscopic examination revealed the gastric mucosal bridge between the double ulcers. The double ulcer healed after an eradication therapy of H. pylori, but the gastric mucosal bridge has remained there on the gastrointestinal endoscopy. The gastric mucosal bridge with Behçet's disease has not been reported in Japan, being considered to be very rare.

Aged↗
PubMed1975

Incidental appendicectomy with laparotomy for trauma.

Incidental appendicectomy was performed in 83 of 206 patients undergoing laparotomy for abdominal trauma. No organs were injured in 42 per cent of the appendicectomy patients and in 17 per cent of the non-appendicetomy patients, thus making comparison between the groups unreliable. While the incidence of intestinal perforation was 21 per cent in the appendicectomy patients, the rate of wound infection was only 7 per cent. One complication (pelvic abscess) was possibly attributable to incidental appendicetomy. Since males below the age of 50 face a significant risk of future appendicitis and represent the majority of patients with abdominal trauma, it may be advisable to perform incidental appendicectomy with laparotomy for trauma in such patients. Specific indications for incidental appendicectomy during laparotomy for trauma are suggested.

Abdominal Injuries↗
PubMed2002

Severe liver haemorrhage during laparotomy in very low birthweight infants.

UNLABELLED: A review is presented of severe liver haemorrhage as a serious complication in surgery on very low birthweight (VLBW) infants. Clinical data and pathological findings, as well as the outcome of the treatment, of five VLBW infants (<1000 g) who experienced liver haemorrhage during surgical exploration for necrotizing enterocolitis or spontaneous intestinal perforation were reviewed retrospectively. At the time of surgery, all infants had signs and symptoms of impending sepsis. The bleeding was predominantly "spontaneous" without obvious iatrogenic liver damage. In three infants, severe liver haemorrhage could be stabilized by early liver tamponade using absorbable thrombostatic sponges and polyglactin mesh. CONCLUSION: Intraoperative liver haemorrhage potentially life-threatening complication of surgery in preterm infants, which is not frequently investigated. Immediate perihepatic liver packing may be used to achieve adequate bleeding control.

Enterocolitis, Necrotizing↗
PubMedDate not supplied

[Peritonitis and infection in children with idiopathic nephrotic syndrome].

We analyzed episodes of peritonitis and/or sepsis associated with the idiopathic nephrotic syndrome (ns) in 23 children treated between 1975 and 1985 at our clinic. 37.5% of the children with infantile ns, 16% of those with steroidsensible ns, and 13.6% of those with steroidresistant ns developed peritonitis. Children with infantile ns and one girl with gram-negative secondary peritonitis presented with sepsis. 3 septic children died. Four patients developed peritonitis secondary to intestinal perforation. The most common bacterial pathogen in primary peritonitis was S. pneumoniae (7 patients). 7 cases were culture-negative. All episodes of peritonitis coincided with an active nephrotic syndrome: in more than half of the patients therapy with corticosteroids had already been started. Eight patients underwent surgical exploration for presumed appendicitis, but none was confirmed by histological examination of the appendix. In 2 instances S. pneumoniae was cultured from ascitic fluid. Prophylactic polyvalent pneumococcal vaccination and early start of corticotherapy during the acute illness of ns is warranted.

Abscess↗
PubMed1999

[Successful treatment of a right atrial thrombus secondary to central venous catheterization].

The authors report on the thrombolytic therapy in an infant born after 36 weeks of gestation weighing 2800 grams. She was repeatedly operated on for intestinal perforation and a right atrial thrombus developed as a complication of the central venous catheterisation. Complete dissolution of the thrombus was observed after 5 days of local urokinase infusion (initial dose: 3000 IU/kg/hr, gradually elevated up to 4500 IU/kg/hr) through an Epicutaneocava catheter positioned in the right atrium. Subsequently, prophylactic intravenous heparin infusion (100 IU/kg/hr), then subcutaneous low-molecular-weight heparin (2 x 100 AXa IU/kg/day) was given. No side effects of the treatment was observed. On follow-up examinations at the age of 5 months the infant proved to be healthy.

Catheterization, Central Venous↗
PubMed1992

Injuries to the bowel and bladder.

The initial challenge facing the traumatologist in the management of bowel and bladder injuries is prompt diagnosis. Intestinal perforations following penetrating trauma are caused by direct penetration or by blast effect, and are most commonly diagnosed by physical examination (signs of peritoneal irritation) or peritoneal lavage. Bowel rupture from blunt trauma is more difficult to diagnose and results from different mechanisms of injury including crushing between the spinal column and the offending blunt object, shearing of the bowel and mesentery at fixed points from sudden deceleration, and rupture secondary to sudden increase in intra-abdominal pressure. Bladder rupture is most commonly seen in association with pelvic fractures, and the diagnosis is made by a well-performed cystogram. This article presents essentials for diagnosis and therapeutic strategies.

Humans↗
PubMedDate not supplied

Mesenteric arterial thrombosis complicating congenital nephrotic syndrome of Finnish type: report of one case.

A female, term neonate presented with generalized edema, heavy proteinuria, hypoalbuminemia and hyperlipidemia in the second week of life. The clinical and laboratory features were compatible with the diagnosis of congenital nephrotic syndrome. Treatment included albumin infusion, empirical penicillin, steroid and continuous arterio-venous hemofiltration. Intestinal perforation developed at the 19th day of age and led to a fatal outcome. At autopsy, thrombosis of the superior mesenteric artery and its branches was noted, and histology of the kidney was compatible with congenital nephrotic syndrome of the Finnish type. The risk of thromboembolism, arterial or venous, should be considered in patients with nephrotic syndrome, even in the neonatal period. Preventive measures, including avoiding volume depletion and femoral arterial/venous puncture, are essential in managing these patients. Prophylactic anticoagulation and infusion of fresh frozen plasma may be warranted to avoid such potentially lethal complications of thromboembolism.

Female↗
PubMed2004

Yersinia enterocolitica intestinal infection with ileum perforation: report of a clinical observation.

Yersinia enterocolitica infection is responsible in human beings for ileocolitis appearing with abdominal pain, diarrhoea and fever. This kind of disease usually heals spontaneously with no remarkable complication. Intestinal perforation is a rare complication of the disease. To date only eleven cases of surgical complications arising from abscess and intestinal perforation due to Yersinia enterocolitica have been reported in literature. In our clinical case the patient, who had previously undergone appendicectomy, required urgent surgery for pelvi-peritonitis due to intestinal perforation on necrotic-ulcerative ileitis with adenomesenteritis from Yersinia enterocolitica. The surgical treatment combined with intestinal resection and targeted antibiotic therapy have proved to be effective.

Adult↗