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Results for “INTESTINAL PERFORATION”

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PubMed1991

Intestinal perforation in a two-year-old child with eosinophilic gastroenteritis.

A two-year-old boy underwent a laparatomy for an intestinal perforation due to eosinophilic gastroenteritis. He had marked peripheral blood eosinophilia and a small duodenal biopsy showed heavy eosinophilic infiltration in the mucosa. After 1 1/2 year on a restricted diet, a control duodenal biopsy showed only slight eosinophilia. Perforation of the small intestine is a rare but serious complication in eosinophilic gastroenteritis.

Child, Preschool↗
PubMed2001

Neonatal intestinal perforation in a developing country.

Between 1990 and 1999, 14 neonates with intestinal perforation were treated at the Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Median age at presentation was 9 days and median weight 2.65 kg. Five had high anorectal malformation, three Hirschsprung's disease and two ruptured exomphalos with bowel strangulation. Gastroschisis, strangulated inguinal hernia, ileal atresia and umbilical sepsis with evisceration accounted for one case each. Two of the perforations were iatrogenic during colostomy construction. Seven perforations were in the small bowel and seven in the colorectum. Three neonates had oedema and tenderness of the anterior abdominal wall, and pneumoperitoneum was seen in abdominal radiographs in two. All the infants had laparotomy, four under local anaesthesia, after resuscitation. Three had simple suture of the perforation, five had resection with primary anastomosis and six had exteriorization colostomy. Overall, eight (59%) died, five with colorectal perforation and three with small bowel perforation.

Anastomosis, Surgical↗
PubMed1998

[Two elderly patients with intestinal perforation caused by press-through package].

We report two cases of intestinal perforation caused by accidental swallowing of Press-Through Packages (PTP). The first case occurred in a 90-year-old woman with moderate dementia. She was admitted to our hospital because of abdominal pain and intestinal obstruction. She showed symptoms and sign of peritonitis and underwent abdominal surgery. The postoperative diagnosis was diffuse peritonitis due to a perforated rectal ulcer caused by the sharp corners of an accidentally swallowed PTP. The second case occurred in an 82-year-old woman with recurrent symptoms and signs of intestinal obstruction. She underwent abdominal surgery and the operation revealed an ileal perforation due to penetration by the sharp edge of a PTP. Both patients were discharged in good condition. PTPs are rapidly becoming popular as packaging for tablets and capsules. However, reports of accidental swallowing of PTPs have recently been increasing. In most cases, the PTPs were found in the esophagus and removed endoscopically. Progression of accidentally swallowed PTPs to the intestines is rare. However, when this occurs, the patient's condition becomes more serious. We propose that drugs should not be dispensed in PTPs but rather handed to the patients, especially to elderly patients, or when impossible, the corners of PTPs should be rounded.

Aged↗
PubMed1992

Multiple cytomegalovirus-related intestinal perforations in patients with acquired immunodeficiency syndrome. Report of two cases and review of the literature.

We present two cases of patients with acquired immunodeficiency syndrome who, in the course of their disease, suffered multiple intestinal perforations that were directly related to cytomegalovirus infection. Biopsy and surgical specimens and autopsy findings in both cases revealed extensive lesions of gastroenteritis; the gastroenteritis was characterized by randomly distributed deep ulcers, resulting in multiple perforations. The main characteristic histopathologic finding was the association of intestinal lesions with a severe form of cytomegalovirus-related occlusive vasculitis. This report provides evidence that supports the contention that cytomegalovirus is the primary causal agent of gastrointestinal lesions affecting immunocompromised patients.

Acquired Immunodeficiency Syndrome↗
PubMed1983

[Intestinal perforation in juvenile abdominal typhoid].

Eight of 19 children with typhus abdominalis who were between 4 and 12 years of age, showed perforation of the intestine. The terminal ileum was always the site of the perforation. Besides the clearly visualized air, meteorism of the small intestine was always seen. In individual cases, segments of the small intestine were seen in close proximity to each other, or an ileus developed. The x-ray film in typhus abdominalis in childhood shows the same signs as an adult x-ray. A characteristic feature of the perforation is its localization in the terminal ileum and the time at which it occurs, namely, between the end of the 2nd and the end of the 4th week of the diseased condition.

Child↗
PubMed2002

Factors effecting morbidity in typhoid intestinal perforation in children.

To determine the factors affecting morbidity in patients with typhoid intestinal perforation (TIP), 42 patients who had been operated upon for TIP between 1990 and 2000 were reviewed. The average age was 10.4 years, the male-to-female ratio 2.5/1. The mean interval from admission to operation was 6 h. Twenty-three children had multiple perforations. Primary closure (PC) was performed in 55% of the patients, ileostomy in 26%, and resection with anastomosis (RA) in 19%. Parenteral nutrition (PN) was available for 22 patients for an average of 9 days. Postoperative complications occurred more commonly in patients with delayed admission and/or severe peritonitis. Hospitalization was shorter and the postoperative complication rate lower in patients who received PN and in those who underwent ileostomy. None of the patients developed an enterocutaneous fistula. The 2 deaths (4.8%) resulted from overwhelming sepsis. The most significant factors affecting morbidity were prolongation of perforation-operation interval and severe peritonitis. No operative procedure is likely to be the best in all cases; therapy should be individualized. Ileostomy appears to be an effective procedure, particularly in patients with severe abdominal contamination and delayed presentation. The use of PN in addition to standard medical and surgical therapy in patients with TIP may be beneficial.

Adolescent↗
PubMed1985

Intestinal perforation associated with indomethacin treatment in premature infants.

Within 9 months we observed intestinal perforations in three very low birth weight (VLBW) infants undergoing indomethacin treatment for symptomatic patent ductus arteriosus (sPDA). The three patients exhibited striking similarities in their clinical courses and predisposing factors. Although clinical and histological criteria did not differentiate the perforations from necrotising enterocolitis (NEC), a well-known entity in premature infants, these events were remarkable to us since we had observed no other cases of NEC in recent years. From animal experiments and pathophysiological data, a role for indomethacin in gastrointestinal ischaemic damage must be considered. This communication is not meant to discredit indomethacin treatment. However, awareness of potential complications and careful monitoring during treatment is warranted.

Ductus Arteriosus, Patent↗
PubMedDate not supplied

Intestinal perforation due to phytobezoar obstruction.

Phytobezoars are rare causes of acute abdomen cases. Here we are reporting two cases which were presented with acute abdomen symptoms and later were found to be small intestinal perforation due to bezoar.

Adult↗
PubMed2002

Laparotomy in very small premature infants with necrotizing enterocolitis or focal intestinal perforation: postoperative outcome.

BACKGROUND/PURPOSE: Laparotomy for peritonitis secondary to necrotizing enterocolitis (NEC) or focal intestinal perforation (FIP) has been supplanted by peritoneal drainage (PD) as the initial treatment in many institutions. Although proponents regard it as a safer alternative, early mortality is cited between 21% and 36%, with subsequent laparotomy required for worsening disease in 26% to 83% of patients. The current outcomes for initial laparotomy are analyzed and compared with those cited for PD. METHODS: A retrospective review of very small premature infants less than 1,500 g undergoing laparotomy for NEC or FIP between 1994 and 2000 was performed. RESULTS: Thirty-five neonates were identified with a median weight of 741 g (range, 460 g to 1,415 g) and a median age of 26 weeks (range, 23 to 33 weeks). Twelve patients had FIP and 23 had NEC including 5 with pan-intestinal necrosis (PIN). No deaths occurred during laparotomy or stoma closure. Seven (20%) patients died within the immediate 7-day postoperative period. Nine (26%) patients died in the 30-day postoperative period. CONCLUSIONS: With current peri-operative management, mortality rates for initial laparotomy and PD are comparable. Assessing the extent of disease and removing necrotic bowel at initial laparotomy can hasten recovery and eventual discharge while enabling informed surgical decision making and advice to parents.

Cause of Death↗
PubMed1975

[Intestinal perforations caused by food foreign bodies].

Accidental ingestion of foreign bodies is common enough, especially in children, but is of relatively small importance as such objects readily pas through the body and no particular treatment is required. A more interesting and less frequent occurrence is the ingestion of objects such as bone fragments, fish bones, etc. that form part of ordinary food. Cases of intestinal perforation caused in this way are described, together with their clinical and surgical management.

Adult↗
PubMed1995

Congenital miliary tuberculosis with intestinal perforations.

The case of a male preterm baby who had congenital miliary tuberculosis with multiple intestinal perforations is reported. The patient was successfully treated with antituberculosis chemotherapy and surgical repair along with other supportive therapy. This is one of the rarest cases of the type described here.

Humans↗