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PubMedDate not supplied

Intestinal obstruction by overdistension of a jejunostomy catheter balloon: a salutary lesson.

Jejunostomy is an alternative method for feeding patients who cannot be fed orally. However, there may be an associated morbidity and potential mortality. In the case presented, overdistension of a jejunostomy catheter balloon led to intestinal obstruction and pressure necrosis (of the small bowel), with subsequent abscess formation leading to death from septicemia.

Aged↗
PubMed1995

Intestinal obstruction and bilateral ureteral injuries after laparoscopic oophorectomy in a patient with severe endometriosis.

The overall frequency of ureteral injury during laparoscopic adnexectomy for endometriosis is unknown, and intestinal obstruction after laparoscopy is rare. Our patient had two postoperative complications: small bowel obstruction and bilateral ureteral injuries discovered 2 and 39 days, respectively, after outpatient laparoscopic adhesiolysis and bilateral salpingo-oophorectomy for severe endometriosis. Pelvic examination and vaginal sonography revealed a large unilocular cystic mass. Laparoscopy showed a fixed large endometrioma firmly attached to pelvic peritoneum and intestines in the pelvic cavity, and significant adhesions in the upper part of a midline incision from prior abdominal hysterectomy. These midabdominal adhesions were not released. The patient underwent laparoscopic bilateral adnexectomy as an outpatient. Two days later she was admitted with small bowel obstruction. Thirty-nine days later, diagnostic evaluation revealed urinary ascites with right ureteral stricture at the uterine artery level, and complete ligation and resection of the left ureter at the pelvic brim near the infundibulopelvic ligament stump. She underwent left ureteral implantation with psoas hitch and right ureterolysis. Follow-up cystogram and intravenous pyelography at 6 and 20 weeks revealed complete recovery. In cases of severe endometriosis with significant ureteral and intestinal involvement, laparotomy may have to be considered.

Adult↗
PubMed1975

Studies on small intestinal obstruction. VI. Blood circulation in moderately distended small bowel after obstruction.

Feline small-bowel circulation was studied during in vitro homologous perfusion of denervated intestine after in vivo obstruction. The bowel specimens showed delayed compliance and, when compared with non-obstructed specimens, enhanced distensibility. Bowel specimens investigated during continuous distension had a normal regional vascular resistance and a normal capillary filtration coefficient (CFC) but a somewhat decreased oxygen utilization; artificial distension to 20 mmHg caused a resistance enhancement and a profound (80-90%) reduction of CFC but did not prevent oxygen consumption from attaining normal levels. An artificial distension occasions an augmentation of regional vascular resistance, whereas the distension caused by intestinal obstruction does not; the significance of this observation is discussed. Bowel specimens investigated after intra-operative decompression showed normal vascular resistance, normal CFC and normal oxygen consumption; artificial distension to 20 mmHg produced a resistance enhancement and a moderate (40-50%) reduction of CFC; oxygen consumption was not affected. Thus, an intra-operative decompression involves no augmentation of regional vascular resistance and seems to increase the ability of the capillary bed to withstand, with retained function, a renewed distension. After release of the distension, flow reduction and resistance enhancement persisted, whereas CFC returned to basal values in both groups of specimens; oxygen consumption remained on stable levels. It is emphasized that the persisting augmentation of resistance observed after decompression of the bowel is related to the in vitro situation, whereas in vivo intra-opertive decompression of obstructed bowel seems to involve no consequences of this kind. Some experiments featured fluid output to the gut lumen in the post-distension period; this observation is discussed. A normal rate of oxygen utilization accompanied the profound reduction of perfused capillary surface area noted in obstructed gut upon a moderate additional distension; possible mechanisms underlying this finding are discussed. It is concluded from the present study that a simple small-bowel obstruction, although not per se involving any serious threat to the bowel viability, renders the gut wall vulnerable to any further increment of distension or ischaemia. It is suggested that this is mainly the result of enhanced distensibility in the wall of the obstructed gut.

Animals↗
PubMed1989

Intestinal obstruction in a neonate with adrenal hemorrhage and renal vein thrombosis.

Adrenal hemorrhage and renal vein thrombosis are two distinct vascular entities encountered in the newborn period. Occasionally, both entities may co-exist in the same patient. A premature infant of a diabetic mother presented with intestinal obstruction secondary to extrinsic compression by the mass effect of the enlarged hemorrhagic adrenal and thrombosed kidney on the left hemicolon, a phenomenon which to our knowledge has not previously been described.

Adrenal Gland Diseases↗
PubMed1979

[Intestinal obstruction following necrotizing enterocolitis (author's transl)].

The increase in survival from necrotizing enterocolitis results in an increased rate of late sequelae. We would like to take the opportunity to emphasize these new complications by a review of our patient material. 11 (23.9%) patients from a total number of 46 showed signs and symptoms of intestinal obstruction at different points in the course of the disease. In two surviving patients out of this group of 11, a resection of postinflammatory gut stenosis had to be performed within the first year. In the 9 children who died, particular emphasis is being paid in the autopsy reports to obstructive lesions in the gastrointestinal tract. Due to this rather frequent event (23.9%) of postinflammatory formation of strictures and stenoses in the recovery from NEC a functional radiographic study of the intestinal patency seems mandatory before discharge of any patient with NEC with operative or conservative treatment.

Enterocolitis, Pseudomembranous↗
PubMed2004

Distal intestinal obstruction syndrome in adults with cystic fibrosis.

BACKGROUND & AIMS: With the improved survival of patients with cystic fibrosis (CF), gastrointestinal complications become more evident in adults with this condition. The aims of this study were to determine the prevalence and clinical features of distal intestinal obstruction syndrome (DIOS) and its relationship with the cystic fibrosis transmembrane conductance regulator (CFTR) genotype in an adult CF population. METHODS: Cross-sectional study was conducted in an adult CF cohort. RESULTS: Among 171 adults with CF (mean age, 28.9 years), 27 patients (15.8%) reported 43 episodes of DIOS. No significant association was found between DIOS and a history of meconium ileus. The first episode of DIOS occurred in adulthood in 21 cases (77.8%). DIOS recurred in 13 patients (48.1%). All patients who developed DIOS had pancreatic insufficiency. Pulmonary function was significantly more altered in patients with DIOS than in the other patients, but pancreatic insufficiency and age might act as confounding factors. DIOS occurred in 21.9% of patients with a severe CFTR genotype and in only 2.4% of patients with a mild CFTR genotype (P < 0.005). CONCLUSIONS: DIOS is frequent in adults with CF with a severe CFTR genotype and/or advanced-stage pulmonary disease. The relative contributions of malabsorption and impaired intestinal secretion in the development of DIOS are discussed.

Adolescent↗