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 1,207 records · Page 67Linked to original sources
PubMed1972

[A case report of intestinal eosinophilic granuloma du to Ascaris Ova]

This is a case report of intestinal eosinophilic granuloma caused by Ascaris ova and worm which is supposed to be rare in Korea. CASE: A 23 year old healthy female reached Pusan Sanitation Hospital with complaints of high fever and abdominal pain on December 3 in 1966. Examination: Her temperature was 99.6'F. Pulse 80. Abdominal palpation showed muscle rigidity and tenderness. On the right side of the abdomen diagnosis due to ruptured appendix was made, and a laparotomy was performed the same day. OPERATION: Intestinal perforation by a Ascaris worm in the caecum about 7 cm from the ileo-caecal junction was also found. The worm was liquefied already. The intestine was edematous. Numerous rice sized nodules were seen on the intestine. The omentum was markdly inflammed and was adhered with a fist size mass. The mass and appendix were also resected in order to do a histological study. PATHOLOGY: Two kinds of tissues were examined : one a mesenteric mass, the other lymph node. MICROSCOPICALLY: it showed intensive and entirely necrotic tissue in which numerous parasitic ova were surrounded by granulomatous inflammatory cells with eosinophiles. The parasitic ova were degenerative and partialy necrotic although they had three layers of egg shell which are identified with Ascaris ova.

Journal Article↗
PubMed1985

Analytical diagnostic peritoneal lavage in the diagnosis of intra-abdominal injury.

Diagnostic peritoneal lavage (DPL) was modified to detect dynamic changes occurring in lavage fluid in dogs following liver, spleen, or intestinal injury. In 33 animals lavage fluid was serially sampled over 75 minutes and analyzed for RBC and other variables. The spun sediment was Gram stained. In control groups, either saline or autologous blood was instilled into the peritoneal cavity at a known rate. In these experiments, the composition of lavage fluid did not significantly change over time. Blood infused at a constant rate into the abdominal cavity produced corresponding, continuing increases in the RBC count. In experimental groups, the liver, spleen, or intestine were injured before lavage. Only initial RBC counts greater than 1 million/mm3 or rising RBC counts in serial lavage samples were associated with life-threatening hemorrhage. Gram stains of samples were positive for bacteria in 43% of fasted dogs and in 80% of fed dogs with intestinal perforation.

Albumins↗
PubMed1983

[A case of perforation of the small intestine in Crohn's disease].

Perforation of the small intestine occurs rarely in the course of Crohn's disease. A case of perforation of the ileum affected by Crohn's disease was presented. A 92-year-old woman was admitted to the hospital complaining of sudden onset of abdominal pain. Laparotomy revealed peritonitis and two perforations in the diseased ileum. She underwent resection of 60 cm of terminal ileum, ileocecum and adjacent 5 cm of ascending colon with an end-to-end ileocolic anastomosis. The intestinal wall of 40 cm of terminal ileum was thickened and edematous. The bowel lumen was narrow. Several longitudinal ulcers were seen. Histological examination of the resected specimen revealed the perforation in Crohn's disease. The intestinal wall was thickened. The mucosal surface was ulcerated and focally perforated. Ulcerated base was covered by abundant necrotizing mass. The submucosa was replaced by non-caseous inflammatory granuloma comprising with fibroblasts, lymphocytes and plasma cells. Perforated area showed abscess formation with plentiful granulocytes. She died of pneumonia 10 days after operation.

Aged↗
PubMed2006

[Surgical management of chronic radiation enteritis].

OBJECTIVE: To explore the surgical methods and the clinical results of chronic radiation enteritis. METHODS: Treatments were applied to forty-nine cases of chronic radiation enteritis complicated with intestinal obstruction, enterocutaneous fistula, intestinal stenosis, intestinal bleeding, severe proctocolitis and intestinal perforation, among whom 47 cases received an average of 2.8 +/- 2.1 operations. Twenty-six cases received resection of the injured segment with primary anastomosis, fourteen cases received intestinal resection and proximal enterostomy, among whom 6 ostomies were permanent, and another 8 cases received secondary ostomy closure. The injured intestinal segments were spared in 7 cases. RESULTS: Forty-seven among 49 cases were cured (success rate, 96%) with no anastomotic leakage. Two patients died. CONCLUSIONS: Surgical complications of chronic radiation enteritis should be managed operatively. The operative method should be chosen according to the general condition of the patients and the complexity of the abdomen. Perioperative management and proper selection of intestinal segments for anastomosis are essential for the success.

Adult↗
PubMed2003

Pseudo-obstruction in the critically ill.

Intestinal pseudo-obstruction is defined as a clinical syndrome characterized by impairment of intestinal propulsion, which may resemble intestinal obstruction, in the absence of a mechanical cause. It may involve the small and/or the large bowel, and may present in acute, subacute or chronic forms. We have performed a systematic review of acute pseudo-obstruction, also referred to as Ogilvie's syndrome in the literature, and focused on proposed mechanisms, manifestations and management of post-surgery and critically ill patients who suffer from one or more underlying clinical conditions. The hallmark of the syndrome is massive intestinal distension, which is detected on clinical inspection and plain abdominal radiography. The underlying pathophysiological mechanisms are not fully understood. Therefore, treatment focuses on preventing intestinal perforation, which is associated with an average 21% mortality rate.

Critical Illness↗
PubMed1975

["Surgical" laparoscopy indications and value].

From 1971-1973, 1046 patients underwent laparoscopy in the gynecological department; 256 of the cases were surgical problems. In contrast to gastroenterological laparoscopy, surgical laparoscopy was performed in the operating room under general anaesthesia and everything prepared for immediate surgery. Major surgical interventions--if necessary--were performed immediately after laparoscopy. Indications for surgical laparoscopy were the following: preoperative evaluation of nature, extent and eventual metastases of tumors. Preoperative differentiation of acute and chronic appendicitis from other affections, particularly in younger female patients. Suspected intraabdominal hemorrhage of traumatic or non-traumatic origin. Evaluation of pathological palpatory findings in the abdominal cavity. Differential diagnosis of chronic relapsing intraabdominal complaints of unknown origin. Differential diagnosis of putrid, tuberculous or carcinomatous peritonitis with eventual biopsy. Preoperative evaluation of questions concerning surgery of liver, gallbladder or pancreas in connection with occlusive jaundice, hepatic cirrhosis or malignancy. The results of this study show, that by laparoscopy in over 50% of the patients, major surgical interventions could be avoided. Contraindications were primarily limited to pulmonal or cardiac insufficiency. The only complication (intestinal perforation), was adequately dealt with under the given operative conditions.

Abdomen, Acute↗
PubMed1990

Primary ascaridial perforations of small intestine and Meckel's diverticulum.

The clinical presentation of six cases with primary ascaridial perforations of the terminal ileum (4 cases) and Meckel's diverticulum (2 cases), without any associated underlying intestinal disease, is described. All the cases presented clinically as peritonitis and had worm masses in the intestinal lumen with maximal impaction in the terminal ileum. Ileal perforations were surgically closed in two layers after removal of the worms. Diverticulectomy after removal of the worms was performed for Meckelian diverticular perforations. Peritoneal toilet was done in all the cases. Pressure necrosis from the impacted worm masses probably resulted in these perforations.

Ascariasis↗
PubMed2001

Risk factors for complications of laparoscopic Nissen fundoplication.

BACKGROUND: Although the rate of complications from laparoscopic Nissen fundoplication is low and the adverse postoperative sequelae are well known, both are disturbing for the patient. Identifying risk factors could be helpful in the better selection of patients for this procedure. METHODS: A retrospective review of 126 patients with a mean follow-up period of 3.5 years was conducted. The patients' demographics, pre- and postoperative symptoms, and outcomes were analyzed and compared. RESULTS: Three groups of patients were distinguished: (group 1) 9 patients with intraoperative complications (5 with perforation, 3 with hemorrhage, 1 with pneumothorax); (group 2) 16 patients with postoperative complications (5 with severe dysphagia, 4 with failure, 2 with pneumonia, 2 with incisional hernia, 1 with intestine perforation, 1 with fundoplication herniation, 1 with infection, 1 with gastric ulcer); and (group 3) 101 patients without any complications. The patients'demographics, preoperative symptoms, and preoperative studies were comparable in all three groups. The body mass index (BMI) was significantly higher (p < 0.05) statistically in group 1 (32.4 kg/m2) and group 2 (33.6 kg/m2) than in group 3 (28.7 kg/m2). However, the Visick grade and the subjective outcome were similarly good in all three groups. CONCLUSIONS: Although preoperative studies and symptoms do not seem to predict complications of laparoscopic Nissen fundoplication, patients with an increased BMI were at increased risk for complications in this study. Therefore, such patients should be counseled appropriately regarding the greater likelihood of intraoperative and postoperative complications.

Adult↗
PubMed1990

Intestinal injuries missed by computed tomography.

Isolated intestinal injuries are frequently difficult to diagnose using only physical examination and routine laboratory studies. Between 1980 and 1988, ten patients were identified who had intestinal injuries and had computed tomographic (CT) scans before operation. For none of these scans was the initial reading considered diagnostic of intestinal injury. All patients came to laparotomy from 2 hours to 3 days following injury, and no patient died because of missed intestinal injury. Retrospective review of the scans revealed two to be diagnostic of intestinal perforation with free intraperitoneal air or extravasated contrast. The remaining eight scans had findings suggestive of injury. However, six additional patients had similar suggestive findings and had no evidence of intestinal injury. One patient with missed duodenal injury had not been given gastrointestinal contrast. Computed tomographic findings of intestinal trauma may be subtle or nonspecific and require optimal technique and care in interpretation. The timely treatment of this injury continues to rely on a high index of clinical suspicion and serial examinations by an experienced surgeon.

Adolescent↗
PubMed1994

Spontaneous perforation of pyometra: a case report.

Spontaneous perforation is a rare complication of pyometra and is usually associated with uterine cervical occlusion. We report a very rare case of spontaneously perforated pyometra without cervical occlusion. A 56-year-old woman with severe abdominal pain was admitted to our hospital. Exploratory laparotomy was performed because of suspicion of gastro-intestinal perforation with generalized peritonitis. There was no perforation of the stomach, gallbladder, or bowels, but examination of the uterus revealed a perforation of the uterine fundus. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Pathological investigation of the surgical specimen revealed endometritis and myometritis of the uterus; but there was no evidence of malignancy, and the cervical canal was patent. Although spontaneously perforated pyometra is rare, the condition must be born in mind with regard to elderly women with acute abdominal pain.

Abdominal Pain↗
PubMed1993

Risk of infection, infecting flora and treatment considerations in penetrating abdominal trauma.

Infectious complications postoperatively for penetrating abdominal trauma are a major cause of morbidity, which contributes significantly to increased length of hospitalization stay and the cost of patient care. The results of recent studies have suggested that the probability of a major infection after traumatic intestinal perforation of the individual patient can be predicted from risk factors noted at the time of the operation. The factor most closely associated with the development of infection is peritoneal contamination by intestinal contents. Other significant risk factors (p < 0.05) are the number of organs injured, number of units of blood administered, ostomy formation for left colonic injury and patient age. The risk of patients being infected can be predicted and thereby used to guide postoperative treatment decisions. Adjusting trauma care choices in antibiotics, duration of antibiotic administration and incisional wound management could result in significant savings. Standard operative procedures, the use of parenteral antibiotics (the duration of which has been one to two days in most recent studies) effective against endogenous aerobic and anaerobic organisms and leaving the surgical incision open decrease the incidence of postoperative wound infection. Despite such preventive measures, major infection remains a problem.

Abdominal Injuries↗
PubMedDate not supplied

[Clinical characteristics of Meckel's diverticulum in a population of children].

A descriptive and retrospective study was realized during a period of eleven years from January 1983 to December 1993. There were found 101 cases, of which 75.25% were Meckel's diverticulum complicated. The incidence found was of 1.2%. The 89.5% of the complicated cases were less than 10 years old, and the 47.4% were less than 2 years old. The most frequent symptoms were: abdominal pain (68.4%), vomiting (68.4%), fever (47.3%), and abdominal distention (39.4%). The congenital anomalies presented in 17.8%, were: intestinal malrotation, congenital bands, hernia inguinal and omphalocele. The most common complications were: intestinal obstruction (47.4%), diverticulitis (19.7%), lower digestive hemorrhage (15.8%), and intestinal perforation (14.5%) of the cases. The heterotopic tissue was present in 20.7% cases. In our Institute, the age's group less than 2 years old, presented more complicated cases (p < 0.01). The intestinal obstruction was the most common picture (p < 0.001). The lower gastrointestinal hemorrhage was the second complication in patients less than 2 years old (p < 0.05). We found a strong association with other congenital anomalies.

Adolescent↗
PubMed2003

[Clinical management of acute colonic pseudo-obstruction in patients: a systematic review of the literature].

Intestinal pseudoobstruction is a clinical syndrome characterized by impairment of intestinal propulsion, which may resemble intestinal obstruction, in the absence of a mechanical cause. It usually affects the colon but the small intestine may also be involved, and may present in acute, subacute or chronic forms. We have performed a systematic review of the acute form of pseudoobstruction, also referred to as Ogilvie's syndrome. We discuss proposed pathophysiological mechanisms, manifestations and management of this clinical condition in post-surgery and critically ill patients. The hallmark of the syndrome is massive intestinal distension, which is detected on clinical inspection and plain abdominal radiography. The underlying pathophysiological mechanisms are not fully understood. Therefore, treatment has focussed on preventing intestinal perforation, which is associated with a 21% mortality rate.

Acute Disease↗
PubMedDate not supplied

Risk of infection following penetrating abdominal trauma: a selective review.

Post-operative infectious complications following penetrating abdominal trauma are a major cause of morbidity and contribute significantly to increased length of hospitalization and costs of patient care. Our recent study suggests the individual patient's probability of major infection following traumatic intestinal perforation is high and can be predicted from risk factors identified at the time of surgery. The determinant of primary importance for development of infection confirmed by this study is peritoneal contamination by intestinal contents. Other significant risk factors (p less than 0.05) were number of organs injured, number of units of blood administered, ostomy formation for left colon injury, and the patient's age. Risk of infection can be calculated from these data and could potentially be used to guide post-operative decisions. Areas of trauma care in which alteration of therapy might result in significant savings include choice of antibiotics, duration of antibiotic administration, and wound management. This study supports the use of standardized operative procedures and parenteral antibiotics effective against endogenous aerobic and anaerobic organisms. If such observations continue to be supported by further randomized prospective studies, there is tremendous potential to further tailor surgical management for the individual patient in a more cost-effective manner.

Abdominal Injuries↗
PubMed1983

Surfactants selectively ablate enteric neurons of the rat jejunum.

Surfactants, a group of nonspecific membrane perturbating substances, can cause nerve damage. Various concentrations of the cationic surfactants benzalkonium chloride (BAC) and benzethonium chloride, the anionic surfactants sodium ricinoleate, dioctyl sodium sulfosuccinate and sodium lauryl sulfate and the nonionic surfactant Triton X-100 were applied to the serosal surface of the rat jejunum every 5 min for 0.5 hr and then rinsed off with saline. Thirty days after surfactant application, the treated and an untreated segment of jejunum were removed and examined histologically. All surfactants which were tested significantly reduced the number of ganglion cells in the myenteric plexus. In addition, sodium ricinoleate significantly reduced the number of ganglion cells in the submucosal plexus. Higher concentrations of the cationic agents BAC and benzethonium chloride caused a generalized tissue damage including disruption of the smooth muscle, lymphocytic infiltration, intestinal perforation and death. Using BAC as a prototype surfactant, peptidergic neuron distribution and gut electrical activity were examined. BAC treatment markedly reduced the immunoreactivity of somatostatin, substance P, met-enkephalin and vasoactive intestinal peptide in the myenteric plexus. In addition, the electric properties of the smooth muscle were altered. BAC treatment resulted in an erratic, markedly distorted basic electric rhythm and an alteration in spike potential generation. These studies demonstrate that surfactants in appropriate concentrations selectively ablate the myenteric neurons and alter peptidergic neuron distribution and gut electrical parameters in the rat jejunum.

Animals↗
PubMed1997

Complications of pediatric laparoscopic surgery.

BACKGROUND: Surgical complications of laparoscopy most often occur during Veress needle or primary trocar placement. Veress needle punctures are insignificant and require no further treatment, whereas trocar-induced vascular injuries can be catastrophic. The frequency of vascular and viscus injuries is difficult to calculate because several complications are not reported in the literature. METHODS: During a 10-year-period (1984-1995), at the Division of Pediatric Surgery at "Federico II" University of Naples, 430 laparoscopic procedures were performed in 395 children with a mean age of 5 years. The incidence of complications related to laparoscopy was 1.8% with eight complications, one of which was rather severe. The complications included one abdominal wall hematoma, two perforations of abdominal viscus (stomach, ovary), one umbilical scar complication, one postoperative hydrocele, one subcutaneous emphysema, and one pneumothorax during a Nissen procedure. The only severe complication occurred in a young girl with neurologic problems and a kyphoscoliosis operated on via laparoscopy for a gastroesophageal reflux. She suffered injuries of both right common iliac vessels and several intestinal perforations due to blind introduction of the first umbilical trocar. RESULTS: In this case rapid conversion, complex vascular reconstruction, and multiple intestinal sutures were performed. The Nissen fundoplication with pyloroplasty was performed traditionally and the patient left the hospital free of symptoms after 20 days. The other seven complications were resolved without any problem intra- or postoperatively. CONCLUSIONS: The authors believe that the open approach with a blunt trocar is most important in helping to avoid complications in pediatric laparoscopy.

Adolescent↗
PubMedDate not supplied

Pneumatosis cystoides of the right colon: a possible source of misdiagnosis. Report of a case.

Pneumatosis cystoides intestinalis is a rare condition that can be located in any part of the gastrointestinal tract. It is usually associated with a wide variety of gastrointestinal or pulmonary diseases. The primitive form is much less frequent and usually involves the left colon. The pathogenesis of pneumatosis cystoides intestinalis is still unclear. The mechanical theory, which is the most accepted explanation, postulates that gas is forced into the bowel wall by breaks in the mucosa; this is more likely to occur when the intraluminal pressure is higher, as happens in obstructive conditions, during endoscopies, or during infections from gas-forming bacteria. Pneumatosis cystoides is often asymptomatic, representing an occasional finding during investigations for other abdominal conditions. Complications occur in about 3% of cases and include obstruction, intussusception, volvulus, haemorrhage and intestinal perforation. When presenting acutely or in association with other abdominal conditions the differential diagnosis is rarely a problem. More important is to diagnose asymptomatic primitive submucosal pneumatosis of the colon, in order to avoid unnecessary intestinal resections. The Authors present the case of a patient with pneumatosis coli who underwent laparotomy for a suspected colonic lipomatosis of the right colon.

Colon↗