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Results for “Intestinal Fistula”

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At least 1,135 records · Page 63Linked to original sources
PubMed1991

Ornithine decarboxylase is involved in repair of small intestine after ischemia-reperfusion in rats.

To assess whether ornithine decarboxylase (ODC) is involved in mucosal repair after ischemia-reperfusion (I/R), two approaches were used: 1) measurement of mucosal ODC activity at different intervals after I/R, and 2) inhibition of ODC activity with alpha-difluoromethylornithine (DFMO, an irreversible inhibitor). In the first series of experiments, rats were allowed to recover after superior mesenteric arterial occlusion (10 min) before harvesting the intestinal mucosa for measurement of ODC activity. ODC activity increased markedly 6 h after I/R, and greater than 72 h were required for enzyme activity to return to normal. DFMO treatment completely abolished the I/R-induced increase in ODC activity. In another series of experiments, rats with an intestinal lymph fistula were infused intraduodenally at 3 ml/h with vehicle or 2% DFMO in vehicle immediately after I/R. Lipid absorption was measured at 24 and 48 h after I/R. In the DFMO group, lymph radioactive lipid output at 24 h after I/R was significantly lower compared with time-matched sham-operated controls. Lymph lipid output in rats receiving the vehicle was restored to a normal level at 48 h after I/R. However, this restoration of normal lymphatic lipid transport at 48 h I/R was not observed in the DFMO group. These observations indicate that ODC activity plays an important role in the repair process that results in complete restoration of mucosal function 2 days after I/R.

Animals↗
PubMed2003

Surgical treatment of severe inflammatory bowel diseases.

Surgical treatment of severe inflammatory bowel diseases is required in failed medical treatment, in emergencies and for complications. Indications for surgery and operative techniques have changed significantly over the last few years. There is a clear tendency towards earlier and less invasive surgical interventions performed in specialized and experienced centers. Improved quality of life of patients with Crohn's disease or ulcerative colitis after surgical therapy supports an earlier consideration of the surgical treatment option. A close cooperation with the involved gastroenterologist is mandatory in this context.

Colitis, Ulcerative↗
PubMed1985

[General management and operative therapy of progressive or recurrent ovarian cancer].

High relapse rates and poor therapeutical results of a secondary chemotherapy or of surgery and radiation can be expected in advanced ovarian carcinoma. Supportive care must stand in the foreground of therapeutical attention. Furthermore, intraperitoneal forms of therapy (radioisotopes or cytostatic agents) must be tried out. Rectal obstructions occur in about 35% of all patients. A successful operation leads to a prolongation of the survival time.

Combined Modality Therapy↗
PubMed1992

Nutrition support in inflammatory bowel disease.

Many patients with the inflammatory bowel diseases, Crohn's disease, or ulcerative colitis have significant protein-calorie malnutrition and micronutrient deficiencies. Factors that contribute to these nutritional deficits include inadequate nutrient intake, malabsorption, excessive nutrient secretion across the diseased gastrointestinal tract, drug-nutrient interactions, and increased nutrient requirements. In this review, the use of enteral and parenteral nutrition support as primary therapy for active Crohn's disease and ulcerative colitis is discussed. Other roles for nutrition support in patients with inflammatory bowel disease, including preoperative nutrition support, nutritional treatment of intestinal fistulas and growth retardation, and home parenteral nutrition for gut failure, are also reviewed.

Deficiency Diseases↗
PubMedDate not supplied

Use of parenteral nutrition in patients receiving isolated kidney or simultaneous pancreas/kidney transplantation.

BACKGROUND: There is little information available on the use of parenteral nutrition (PN) in patients after a kidney (KID) or simultaneous pancreas-kidney (SPK) transplantation. This study examined the indications and use of PN in these patients. METHODS: Retrospective study of 25 patients (12M/13F; mean age: 51 +/- 11 years old) receiving PN after KID or SPK transplantation. Patients were divided in 2 groups according to the number of PN days (group A = <7 days and group B = >7 days). RESULTS: Overall mortality was 16% (group A: 0/7; group B: 4/18). Postoperative ileus (n = 7), intestinal fistula (n = 5), and nausea/vomiting (n = 4) were the most common indications for PN. Functional disorders accounted for 56% (14/25) of the indications for PN. Factors differentiating group A (7/25; median = 5 [4-6] days) from group B (18/25; median =9 [7-31] days) included a significantly higher preoperative serum albumin, SPK transplantation for the first time, and diagnosis of ileus as the indication for PN initiation. CONCLUSIONS: Functional disorders of the digestive tract are the primary reason for initiation of PN in isolated KID and SPK transplantation patients. Well-nourished patients undergoing their first SPK transplantation who develop postoperative ileus usually do not need nutrition intervention.

Female↗
PubMedDate not supplied

An enteral elemental diet for infants and children with surgical disorders.

Sixty-nine infants and children with surgical disorders were fed an enteral elemental diet consisting of synthetic L-amino acids, dextroglucose, soybean oil, electrolytes and vitamins. Satisfactory clinical results were achieved in 55 patients, whose average positive nitrogen balance was approximately 578 mg/day in neonates, 1,518 mg/day in infants and 2,452 mg/day in children; average weight gain was approximately 16 g/day in neonates, 23 g/day in infants, and 21 g/day in children during total enteral nutrition with the diet. Elevation of serum transaminase values was noted in 5 patients receiving total enteral nutrition with the diet. Liver toxicity may have been caused by the composition of amino acids of the diet, solely free amino acids as protein component. However, the diet provided a valuable therapeutic alternative to total parenteral nutrition in selected infants and children requiring surgery.

Child↗
PubMed1979

Surgical treatment of intestinal complications after radiotherapy and surgery for malignant lymphoma and carcinoma of the testis.

The aim of this paper is the analysis of the complications occurred after surgical and radiological procedures, for staging and treatment of malignant lymphomas and testicular carcinoma with an evaluation of the possible efficacy of their surgical treatment. At the Istituto Nazionale dei Tumori of Milan during the period 1970-1976, 718 patients with malignant lymphomas were staged with laparosplenectomy; 444 of them received radiotherapy on the abdominal area. Laparosplenectomy was not performed on other 123 cases that were irradiated as well on the abdominal area. Retroperitoneal lymphadenectomy or explorative laparotomy were carried out in 98 patients with carcinoma of the testis and 46 of them received adjuvant radiotherapy; other 29 were irradiated without previous surgical procedures. After surgery alone morbidity and mortality rate were 2.7% and 0.73% respectively. The mortality/morbidity ratio was 26%. The incidence of complications after radiotherapy alone was 3.3%. No deaths followed the treatment. Combined treatment had a morbidity rate of 5.5% and mortality rate of 2%. The mortality/morbidity ratio was 37%. Complications were treated mainly by surgery: out of 50 interventions, 22 were intestinal resections. New secondary complications were however frequent (more than 50% after intestinal resection) especially in patients originally treated with laparosplenectomy or retroperitoneal dissection plus radiotherapy.

Gastrointestinal Hemorrhage↗
PubMedDate not supplied

Computed tomography evaluation of diverticulitis.

Acute diverticulitis is a frequent and important diagnosis in gastrointestinal disease, most commonly involving the colon. It is estimated that approximately 15% to 30% of patients with diverticulosis develop symptomatic diverticulitis at some point in the natural history of the condition, often requiring medical and/or surgical therapy. The clinical diagnosis is often difficult to make, and several radiological studies have been used over the past decades to assist in the diagnosis of acute diverticulitis. These include barium enema, ultrasound, and computed tomography (CT). A number of studies over the past decade have shown CT to be the preferable initial examination because of its ability to demonstrate not only the extent of intramural inflammation but also the degree of pericolic disease, including intraperitoneal inflammation, perforation, and abscess formation. Additional benefits of CT imaging include guiding therapeutic interventions in complicated forms of diverticular disease and providing an alternative diagnosis in patients without diverticulitis. The accuracy, techniques, criteria for diagnosis, and staging and applications of CT imaging in acute diverticulitis are discussed.

Appendicitis↗
PubMed2005

Bowel complications in 203 cases of peritoneal surface malignancies treated with peritonectomy and closed-technique intraperitoneal hyperthermic perfusion.

BACKGROUND: Peritonectomy and intraperitoneal hyperthermic perfusion (IPHP) are increasingly used in the management of carcinomatosis of various sites of origin. We analyzed the risk factors for bowel complications with primary anastomoses and the closed technique for IPHP. METHODS: From 1995 to 2004, 203 consecutive procedures were performed at the National Cancer Institute of Milan. We retrospectively analyzed this series of patients. Treated pathologies included peritoneal mesothelioma; pseudomyxoma peritonei; colorectal, ovarian, or gastric carcinomatosis; and abdominal sarcomatosis. All digestive anastomoses were performed before the IPHP. Only one defunctioning stoma was used. RESULTS: We found a bowel complication rate of 10.8%. The bowel complications:anastomoses ratio was 11.3%. On univariate analysis we found a statistically significant association between bowel complications and the following variables: sex, previous systemic chemotherapy status, number of anastomoses ( fewer than two vs. two or more), duration of the procedure (<8.7 vs. >or=8.7 hours), and extent of cytoreduction. After multivariate analysis, male sex (odds ratio [OR], 4.2), no previous systemic chemotherapy (OR, 3.5), and duration of the procedure >or=8.7 hours (OR, 6.3) were considered independent risk factors for bowel complications. CONCLUSIONS: Bowel complications are not increased when primary unprotected anastomoses are performed during peritonectomy and IPHP when the closed technique is used. Male sex, duration of the procedure, and no previous systemic chemotherapy are independent unfavorable risk factors.

Adult↗
PubMed1982

Polytetrafluoroethylene (PTFE): a new material for the construction of gastrointestinal cannulae.

The advantages of polytetrafluoroethylene cannulae are that they are resistant to chemical attack, light in weight, not brittle, inexpensive, adaptable, and they cause minimal tissue reaction. The design of cannulae for cannulation of gastric and duodenal fistulae, and drainage of pouches of the stomach is described. Similar cannulae offer many possibilities for use in other systems.

Animals↗
PubMed1999

Sentinel gem.

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Aged↗