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PubMedDate not supplied

Factors influencing the indomethacin-induced intestinal lesions in the rat.

The influence of various experimental conditions such as partial hepatectomy, administration of hepatotoxic drugs such as carbontetrachloride or ethionine, and starvation on the ulcerogenic activity of indomethacin at intestinal level has been studied in the rat. While lesions produced by oral administration of high doses of indomethacin are reduced by starvation, the incidence of ulcers was significantly increased by partial hepatectomy and by hepatotoxic drugs reaching the maximum of severity (intestinal perforation) in partially hepatectomized animals. These findings suggest that ulcerogenic activity of indomethacin is strictly correlated to the drug metabolising capacity of the liver.

Animals↗
PubMed1994

Unusual clinical manifestation of metastatic pulmonary carcinoma. A case report and review of the literature.

We report a case of ileal metastasis from a clinically evident bronchial carcinoma with an unusual symptomatology due to intestinal obstruction. Only 25 cases of ileal metastasis have been previously reported in the literature in which the diagnosis was made due to the presence of abdominal symptoms related to intestinal perforation in 24 cases. We describe our atypical case with differential diagnosis and review of the literature.

Adenocarcinoma↗
PubMed1975

[Treatment of perforation of the large intestine due to illegal abortion].

Because of perforation of the uterus, lesion of the recto-sigmoid and diffuse peritonitis after illegal abortion, hysterectomy and bilateral salpingo-oophorectomy was performed; the colonic defect was not closed primarily but walled off from the peritoneal cavity; a transverse colostomy was done for fecal deviation and the true pelvis drained vaginally. After the defect had healed smoothly the colostomy was closed.

Abortion, Illegal↗
PubMed2004

Necrotizing enterocolitis in full-term infants: case-control study and review of the literature.

OBJECTIVE: To examine the increasing number of full-term infants at our hospital exhibiting necrotizing enterocolitis (NEC) in order to characterize these cases and to discover common risk factors. METHODS: Medical charts were reviewed for all full-term infants (gestational age > 36 weeks) that were born in our institution during a 5-year period (from January 1, 1998 to December 31, 2002) and that developed definite NEC. Data regarding the rate of Cesarean section (CS) in our institution over the study period and five years prior to the study was also recorded. RESULTS: During the 5 years of the study, 14 full-term infants were found to have NEC. The incidence of NEC in full-term infants increased from 0.16 to 0.71 per 1000 live births in the 5-year period. Mean birth weight was 2829 g. All the NEC infants except one were delivered by CS, and all of them were fed either with a mixture of breast milk and formula or entirely by formula. Seven of the infants (50%) had no major known risk factors predisposing them for NEC. Mean age of disease onset was very early (4.1 days) in most of the infants (12 infants), and the colon was the main NEC site. The short-term outcome was favorable in all but one case, which required explorative laparotomy for intestinal perforation. The number of infants born by CS has been steadily increasing, and was almost three times greater during the study period in comparison to the preceding years. CONCLUSIONS: The etiology of NEC in the full-term population seems to differ from the etiology for the preterm group in its intestinal location and in the timing of its onset. The increase in the rate of CS over the years might be related to the concurrent increase in NEC, and this relationship should be further investigated.Journal

Case-Control Studies↗
PubMed1998

Extracranial giant cell arteritis.

Although giant cell arteritis (GCA) of the extracranial arteries is said to be relatively frequent, clinical manifestations are rarely recognized. We describe a case presenting with intestinal perforation who subsequently died with active GCA of the coronary, mesenteric and temporal vessels.

Aged↗
PubMed2001

Acute abdomen caused by Salmonella typhimurium infection in children.

Salmonella spp. infections can be particularly challenging when they manifest as acute abdominal problems and lead to emergency surgery. Examples of such serious conditions are Salmonella-related intestinal perforation, gallbladder involvement, salpingitis, and peritonitis. Mesenteric lymphadenitis associated with Salmonella typhimurium mimics acute appendicitis and can make it difficult to establish a timely and definitive diagnosis in young patients who present with right lower abdominal pain. Paralytic ileus is a fairly common manifestation of Salmonella infection at all ages, but complete intestinal obstruction requiring surgical intervention is very rare. Because of the nature of the diagnostic process, a significant number of patients with Salmonella infection present with acute abdomen and undergo needless operations. This report describes the cases of 2 pediatric patients who underwent surgery to address persistent pain in the right lower abdominal quadrant and complete intestinal obstruction, respectively. The first patient had inflamed mesenteric lymph nodes that caused appendicitislike symptoms, and the second had dense adhesions between the mesentery and the terminal segments of the ileum that led to intestinal blockage. Serology results showed that both patients' titers for BO ("B and O agglutinating [BO]") antibodies rose to 1:640 in the week after their admission to hospital, a pattern and level that is indicative of S typhimurium infection. J Pediatr Surg 36:1849-1852.

Abdomen, Acute↗
PubMed1981

Surgical treatment of radiation induced injuries of the intestine.

In the patient who has received high dose irradiation of the pelvis and abdomen, all abdominopelvic operations should be avoided, unless it is absolutely essential. Persisting obstruction, hemorrhage, intestinal perforation with peritonitis and with abscess and fistula formation are valid indications for surgical intervention. Ninety-three patients have been operated upon for these complications after irradiation. Some anastomotic dehiscence occurred in ten patients. Six operative deaths occurred. Of the 93 patients, 65 were managed by means of complete resection of the involved segment of intestine, followed by restoration of intestinal continuity by means of an end-to-end anastomosis. This is the treatment of choice when the involved area can be safely resected. In the absence of actual intestinal necrosis and when segments of strictured small intestine are adherent deep in the pelvis, and intestinal bypass procedure may represent the treatment of choice. This was accomplished in 20 patients, two of whom eventually required a second operation for resection of the bypassed segment of intestine.

Adult↗
PubMedDate not supplied

Intestinal tuberculosis with abdominal complications: radiologic and pathologic features.

BACKGROUND: To investigate radiologic and pathological features of intestinal tuberculosis with abdominal complications. METHODS: Twenty-two patients with 23 surgically proven complications (nine intestinal obstructions, eight perforations, three fistulae, and three intestinal bleeds) were analyzed. Medical records, radiologic studies, and pathologic examinations were reviewed with special emphasis on searching for the common features in each group of complication. RESULTS: The most important single feature in seven of the nine patients with intestinal obstruction was the presence of stricture. In the remaining two patients, bowel adhesion was a primary cause of obstruction. In eight patients with intestinal perforation, both obstruction and ulcerations in the dilated proximal loop were the important features in six, and multiple deep ulcerations without obstruction was a primary cause in the remaining two. The common features in three patients with fistulae were focal or multiple strictures, severe adhesions, and fibrotic bowel wall. Intestinal bleeding originated from diffuse mucosal ulcerations. The abdominal complications occurred during antituberculous therapy in 10 of the 22 patients. CONCLUSION: Understanding the radiologic and pathologic features of intestinal tuberculosis with complications help in making an appropriate clinical decision for the treatment strategy. Close observation is necessary, especially in those patients who are acutely ill during antituberculous medical therapy. Enteritis-Intestines, diseases-Intestines, infection-Intestines, perforation-Intestines, stenosis or obstruction.

Female↗
PubMed2003

[Surgical procedure using the tension-free vaginal tape--a safe method for treatment of stress incontinence?].

OBJECTIVE: An importance of knowledge of intraoperative and postoperative complications of tension-free vaginal tape procedure (TVT) in the treatment of female stress urinary incontinence. DESIGN: A review article. SETTING: Obstetrics and Gynecology Department, 2nd Medical Faculty Charles University and Faculty Hospital Motol, Prague. SUBJECT: Complications connected with TVT procedure are classified as intraoperative and postoperative. Postoperative complications are divided into early and late. Bladder perforation is the most common type of intraoperative complication with 0-24% frequency. Hemorrhage (less then 2%) and injury of the obturator nerve (published as case reports only) belong among other intraoperative complications. Voiding difficulties with urinary retention and urge incontinence (about 7%), urinary tract infections (about 4%) and retropubic hematoma (less than 2%) are most frequent postoperative complications. Intestinal perforation, urethral erosion, tape rejection and urethrovaginal fistula belong among very rare but serious complications of TVT procedure. Complications rate relates partly to the experience of the individual surgeon. CONCLUSION: The tension-free vaginal tape procedure is a safety and effective antiincontinent surgical procedure. High cure rate, low complications rate and short recovery time facilitates this procedure for treatment of stress urinary incontinence to the future.

Female↗
PubMed1979

Radiographic manifestations of gastrointestinal tuberculosis.

Barium studies of a gastrointestinal tract and chest radiographs of 109 patients with gastrointestinal tuberculosis were investigated. The type and site of the tuberculous lesions in the bowel, as well as its association with pulmonary tuberculosis and surgical complications, were reviewed. The ileocecal region is the portion of the gastrointestinal tract most frequently involved. The ulcerohypertrophic type of tuberculous lesion was the most common. Thirty-two percent of the patients had a normal chest radiograph. Nineteen patients had a significant surgical complication. Fistulous tracts and intestinal perforation are rare. The radiographic differential diagnosis with regional enteritis and other forms of inflammatory bowel disease is discussed.

Adolescent↗
PubMed1976

Intramural gastrointestinal hemorrhage. Clinical and radiographic manifestations.

The clinical and radiographic manifestations of intramural gastrointestinal hemorrhage are presented together with a review of the literature. The observations described are based on the analysis of 20 cases affecting different segments of the gastrointestinal tract. The pathologic process is induced principally by anticoagulant therapy, bleeding diathesis, or abdominal trauma and occurs as a localized, well-defined, intramural mass or as a more diffuse segmental involvement. The clinical features are nonspecific and can vary from mild crampy abdominal pain to severe shock. Other manifestations include rebound tenderness, muscle guarding, and small bowel obstruction. The duodenum and small bowel are the most frequent sites of involvement. The intestinal mucosal folds may be prominent, stretched, and sharply defined or completely affaced, accompanied by a smooth narrowing. There is rapid clinical and radiographic remission with conservative therapy. Intestinal perforations and fibrotic strictures resulting in small bowel obstruction are a rarity, observed only in the posttraumatic variety.

Abdominal Injuries↗
PubMed1997

Lethal complications in a case of sigmoid diverticulitis. A case report.

A 61-year-old female complaining of arthralgia was repeatedly treated with antibiotics and also with prednisolone. A chronic polyarthritis was assumed. In hospital, leukocytosis of 21.000 was found one day before death as well as moderate anemia. Colonoscopy was rejected by the patient. A computer tomography revealed destructive arthritis of the symphysis, vertebral osteochondrosis L5/S1, and sigmoid diverticulosis. The patient died with clinical signs of central dysregulation. At autopsy, a covered perforation of a sigmoid diverticulum with purulent peridiverticulitis was found. The 5th lumbal vertebra and the symphysis showed hematogenic abscesses. Microabscedating pneumonia, purulent meningitis and hypophysitis, and mycotic aneurysm of the basilar artery with lethal rupture were further results of hematogenic spread. Death was caused by massive subarachnoidal hemorrhage. This history is not untypical for elder patients with complicated diverticular disease. The intestinal perforation is often clinically occult due to only few and unspecific symptoms which cannot be exactly attributed to the colon. In the last ten years, we have found lethal complications of sigmoid diverticulitis at a frequency of 0.32% (5 cases in 1.557 subsequent autopsies). The clinical differential diagnosis included diverticulitis in none of the cases. This underlines the importance of autopsies for quality control in medicine, because modern diagnostic methods such as computer tomography were not able to give the correct diagnosis in these cases.

Aneurysm, Ruptured↗
PubMedDate not supplied

Ostomy or intestinal anastomosis in cases of peritonitis.

Twenty-six patients showing peritonitis due to nontraumatic acute abdomen were submitted to ostomy. Mean age was 51 years (range 25-83), being 13 males and 13 females. Bowel obstruction (BO) was the most frequent cause of peritonitis (11 cases), followed by intestinal perforation (IP) (8 cases), acute mesenteric infarction (AMI) (5 cases), and acute abdomen of inflammatory/infectious origin (AAIO) (2 cases). Brook's ileostomy was performed on 65% of the patients. Jejunostomy was performed only in 4 patients, leading to a bad evolution. Overall mortality was 54%. Primary ostomy or anastomosis in cases of peritonitis constitute a highly controversial theme. Indications and problems involving the intestinal exteriorization in emergency surgery urgency are herein discussed.

Adult↗
PubMed1990

[Use of fibrin glue in prevention and therapy of intra-abdominal adhesions].

In prevention of the recurrent intestinal obstruction we performed at the Department of Pediatric Surgery of the University of Mannheim a sutureless plication of the small bowel with fibrin glue only over the last 7-year period. The postoperative course was uncomplicated in all patients. The clinical and experimental experiences suggest that the high concentrated human fibrinogen is able to start healing of the lesions of the serosa to prevent intraabdominal adhesions prospectively. Furthermore the time saving and easy procedure is to be stressed. First of all the high risk of tissue necrosis or intestinal perforation due to ischemia by sutures and stitches like in the traditional technique of plication is not present.

Animals↗
PubMed1980

Diagnosis of intestinal duplication by 99Tcm-pertechnetate scanning.

A case is described of a 19-month-old boy who presented with melaena. Intestinal duplication was diagnosed by 99Tcm-pertechnetate scanning and was confirmed at operation 2 years later, when the child was admitted with intestinal perforation. The technique is a reliable, non-invasive method for diagnosing ectopic gastric mucosa and is recommended in all cases of unexplained rectal bleeding in children.

Choristoma↗
PubMed2004

Bowel injury as a complication of microdiscectomy: case report and literature review.

Intestinal injury is a rare complication of lumbar disc surgery, resulting from inadvertent penetration of the anterior annulus fibrosus and anterior longitudinal ligament. Patients typically complain of abdominal pain and distention developing over the course of several days. Imaging with plain upright chest radiographs or abdominal computed tomography may demonstrate free air in the abdominal cavity. We report a case of intestinal perforation after microscopic lumbar discectomy and present the diagnostic postoperative imaging. In addition, we review the relevant literature and discuss techniques that may be employed to avoid this complication.

Adult↗