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Results for “Intestinal Fistula”

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At least 1,171 records · Page 65Linked to original sources
PubMedDate not supplied

[Septic shock during the immediate post-partum period revealing a liver abscess in a woman with Crohn's disease].

Liver abscess is a rare complication of Crohn's disease. We report one case in a 27 year-old woman, presenting as a sepsis after delivery. Crohn's disease was quiescent at presentation. Pregnancy was the only predisposing condition. An intestinal fistula was diagnosed by ultrasonography. The patient was treated by antibiotics, bowel resection and surgical drainage of the abscess.

Adult↗
PubMed1979

[Retrograde inhibitory effect of continuous reinstillation of digestive juice in temporary artificial and pathological enterostomies on the secretory digestive flow].

The reinstillation of the digestive juice in the lower end of an enterostomy has a retrograde inhibitory effect on the upper digestive secretions (average inhibition of 30,2%) particularly on the intestinal juice during the digestive syndromes associated with one or several interruptions of the continuity of the bovel. It should be noted, however, that the observation has not been made on normal men, but rather on severely ill patients treated in the intensive care unit of a gastro-intestinal disease department.

Crohn Disease↗
PubMed1975

[Diverticulosis--diverticulitis].

Diverticulosis is found in approximately 5% of people living in western industrialized countries. 95% of these are without any symptoms and do not need any therapy. For prophylaxis of diverticulitis a diet containing non-digestable cellulose and swelling substances is recommended. Complications of diverticulosis like diverticulitis, perforation abscess, or stenosis can necessitate a resection of the sigmoid colon. This should be done before life-threatening complications like free perforation or massive bleeding occur.

Colonic Neoplasms↗
PubMed1975

The Gambee intestinal anastomosis in gynecologic surgery.

The Gambee single-layer, through-and-through, catgut suture anastomosis of the gastrointestinal tract has been in use from 1969 to 1974. Sixty-four anastomoses have been performed on 56 patients with gastrointestinal involvement or pelvic malignancy. There were no operative deaths, and no patients required reoperation for correction of intestinal anastomotic leaks or rupture of the suture line. This experience suggests that the Gambee intestinal single-layer anastomosis may be useful in the management of gastrointestinal complications of pelvic surgery and malignancy.

Adult↗
PubMed1975

Localization of immunoglobulins in intestinal mucosa and the production of secretory antibodies in response to intraluminal administration of bacterial antigens in the preruminant calf.

Immunofluorescent studies of intestinal tissues from young preruminant calves demonstrate the presence of two main populations of immunocytes synthesizing IgA and IgM. These cells had infiltrated the lamina propria of the intestine as early as 4 days of age. There was little evidence of any significant involvement of IgG1 in intestinal immune synthesis of calves at this age although activity was demonstrable in the ileum and colon of one calf. In general there were more IgG2-synthesizing cells than IgG1, but these were few compared with the main populations of IgA and IgM cells. Local antigenic stimulus to the intestinal mucosa of young fistulated calves using extracts of heat-killed Gram-negative bacteria produced antibody in the secretions over a period of approximately 3 weeks. A second administration of a similar antigenic dose produced a similar response indicating the requirement for continuous stimuli to maintain a measurable level of antibody secretion. Gel filtration and antiglobulin assays indicated that the antibacterial activity was predominantly associated with IgA and that IgM also played a significant role. Oral administration of bacterial antigens to colostrum-fed calves from 5 to 8 days of age produced a faecal antibody response, indicating that intestinal secretion could be successfully interrelated with the declining passive antibody to maintain an almost continuous level of intestinal antibody in early life.

Administration, Oral↗
PubMedDate not supplied

False aneurysms of the proximal anastomosis of the arterial prosthesis and the abdominal aorta.

Due to a false aneurysms of the aortic-prosthetic anastomosis ten patients aged 42-74 years underwent surgery. In three patients, an aneurysm occurred twice. One was operated on after the aneurysm had ruptured. Six patients were treated for hypertension. In the course of the primary procedure, in six cases aortic-bifemoral grafts were implanted, in four--an aortic-femoral, and in two aortic-biiliac grafts were used. In six patients end-to-end anastomoses were performed, and in four--end-to-side. Surgical corrections due to the occurrence of a false aneurysm were performed 3 months to 10 years after the original surgery. On reoperation, purulent matter was found in the site of the prosthesis. In two patients, aortic-intestinal fistulas were detected, and in one--an aortic-cecal fistula. In six patients the anastomoses were totally separated. In the course of 13 procedures performed in false aneurysms, five times replaced, single sutures were applied to the entire circumference of the anastomosis in four cases, including one case where an oblong patch was also used, in three cases an extra segment was sutured between the aorta and the previously implanted prosthesis, and the aneurysmal sac was filled with wire in one patient. Eight patients were reoperated, including three repeated procedures due to a false aneurysm of the proximal anastomosis. Moreover, the patency of prostheses was restored, abscesses were surgically opened and procedures were performed in the colon. Four patients have survived, including one with bilateral amputation of lower limbs. The most common cause of death was myocardial infarction. Two patients died due to massive hemorrhage, and one as a result of uremia.

Adult↗
PubMedDate not supplied

The impact of clinical types of disease manifestation on the risk of early postoperative recurrence in Crohn's disease.

BACKGROUND/AIMS: Surgery for Crohn's disease is frequently followed by symptomatic recurrence, which in up to 40% requires reoperation within 6 years. Whilst there is evidence that postoperative medical prophylaxis can be efficient, the results of clinical trials are inconsistent regarding the achieved benefit for the patient. Several parameters have been claimed to indicate an increased intrinsic risk of early surgical recurrence. METHODOLOGY: Patient charts of 287 patients who had undergone abdominal surgery for Crohn's disease were reviewed. Mean follow-up was 4.4 years. Recurrence-free intervals were calculated by the Kaplan-Meier method. A uni- and multivariate analysis was conducted to assess the impact of possible indicators of the need of repeated surgery. RESULTS: Patients with fistulizing type of symptoms, extraintestinal manifestations, corticosteroid treatment or male gender experienced significantly earlier reoperation. Recurrent disease, histologic evidence of inflamed resection margins, patient's age at the time of primary diagnosis and operation and the presence of epitheloid granulomas did not show significant influence on recurrence-free intervals. CONCLUSIONS: We conclude that the natural course of disease after intestinal resection in patients with one or more of these risk factors tends towards earlier recurrence requiring surgical intervention. The risk factors identified in this trial may be useful for patient stratification for randomized trials on the efficacy of medical prophylaxis.

Adult↗
PubMed1975

[Complications following colostomy closure --resection or extraperitoneal closure?].

At the Surgical Clinic of the University Erlangen-Nürnberg 213 colostomies in the period between 1961 and 1971 have been closed. In 88 patients an extraperitoneal procedure and in 125 patients a resection was performed. We recommend resection, because complications (first of all leakage) have been observed less often than in the extraperitoneal method.

Age Factors↗
PubMedDate not supplied

[Hydrolytic splitting of vitamin A esters in the blood].

The retinol and retinylpalmitate content along with the retinylacetate and retinylpalmitate-hydrolase in the blood of the portal vein and in the peripheral blood from the superficial vein of the hind limb of dogs was determined in chronic experiments before and 1, 2, 3 and 4 hours after administration of the vitamin A preparations into the small intestine fistula. The introduction of an oily retinylacetate solution into the fistula was attended both by an increase of the retinylpalmitate content in the blood plasma and the appearance therein of the retinyl-palmitat-hydrolase activity. Introduction of an aquous-colloidal solution of retinyl-palmitate caused a rise in the latter's content in the blood but was not accompanied by the appearance of the retinyl-palmitate-hydrolase activity. In the blood taken on an empty stomach no capacity for retinyl-palmitate hydrolysis was in evidence. It is presumed that the emergence of the retinyl-palmitate activity in the blood following introduction of precisely the oily retinylacetate solution is due to an intensified supply of the pancreatic enzymes into the blood in response to the fat load. The retinylacetate-hydrolase activity was continually present in the blood and did not vary in its intensity in the dynamics of absorption.

Animals↗
PubMed2002

[Laparoscopic sanitation of the abdominal cavity in combined treatment of peritonitis].

Standard methods of treatment were analyzed in 228 patients with general peritonitis of different etiology: sanitation and drainage of abdominal cavity, peritoneal lavage, programmed laparotomy compared with laparoscopic sanitation (LS) performed in 60 patients. A significant decrease in the number of purulent-inflammatory complications, intestinal fistulas and broncho-pulmonary complications were seen after LS. It was most effective for treatment of peritonitis with Mannheim peritoneal index from 16 to 29 points (lethality 11.8%) compared with conventional treatment (p < 0.05). Indications and contraindications for LS, original device "BRUSAN" were developed. Abdominal LS is a highly effective and mini-invasive method of local treatment in general peritonitis.

Combined Modality Therapy↗
PubMedDate not supplied

Surgical treatment of severe late radiation injury to the bowel: a retrospective analysis of 83 cases.

BACKGROUND/AIMS: The aim of this study was to determine the best surgical approach for the treatment of late radiation injury to the bowel. METHODOLOGY: Clinical and follow-up charts of 83 patients operated in our institution for late radiation injury to the bowel were retrospectively reviewed. The type of operation (resection-anastomosis or bypass) mortality, postoperative complications and reoperation rate were recorded. Seventy-six underwent resection with immediate anastomosis. A bypass or viscerolysis was performed in only 7 patients. RESULTS: Postoperative mortality was 2.4%, morbidity was 23. Twenty-seven patients underwent further surgery; early reoperation (within 1 month) was necessary in 12 (morbidity 41%). A late reoperation has been performed in 15 patients (no mortality, morbidity 53.5%). CONCLUSIONS: From the results of our study it can be concluded that resection with immediate anastomosis for late radiation injury to the bowel is safe and should be the first option for these patients.

Adult↗
PubMed1975

Management of massive abdominal wall defects.

Patients with acute losses of large portions of the anterior abdominal wall are discussed. Management is divided into the acute or immediate phase in which initial wound control is paramount, and then a subacute period in which coverage with skin is accomplished. Many weeks later during the chronic phase, reconstructive procedures are done if needed. Methods of handling these defects are presented.

Abdominal Injuries↗