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At least 1,333 records · Page 74Linked to original sources
PubMed1995

Analysis of the kinetics of peritoneal adhesion formation in the rat and evaluation of potential antiadhesive agents.

BACKGROUND: Peritoneal adhesions continue to be a significant cause of postoperative complications. Elucidating the origin of these adhesions has been hampered by the lack of a reproducible animal model. The purpose of this study was to create a standardized model in which a single, specific adhesion could be objectively measured. With this model the kinetics of adhesion formation were then evaluated. A variety of potential antiadhesive agents were then tested and compared. METHODS: In this study a reproducible, quantitative rat model was developed that used uniform defects on the peritoneal wall and cecal surface. The resulting adhesions were subsequently scored, and their strength was measured with a tensiometer. An evaluation of the kinetics of peritoneal adhesion formation was obtained by using a timed removal of silicone elastomer sheeting held between the two injured surfaces. The following antiadhesive agents were evaluated: Ringer's lactate solution; dextran 70 (32%); modified carboxymethylcellulose (1.0% and 2.0%); an absorbable barrier of specially knitted material composed of oxidized regenerated cellulose; fibrin sealant; silicone elastomer film; and expanded polytetrafluoroethylene membrane. RESULTS: Evaluation of the kinetics of peritoneal adhesion formation indicated that the susceptibility for adhesion formation was significantly decreased or eliminated after the first 36 hours. Evaluation of antiadhesion agents indicated that the magnitude of adhesion prevention was directly proportional to the agent's ability to remain at the site of injury during the critical period of adhesion formation. Permanent barriers (silicone elastomer film, expanded polytetrafluoroethylene membrane) provided the greatest antiadhesion effect but were not believed to be ideal agents because they remained at the site of injury well after the critical period of adhesion formation. The incidence of adhesion formation for the other agents was as follows: control (34 of 34), Ringer's lactate (12 of 12), absorbable barrier of knitted cellulose (10 of 10), 32% dextran 70 (8 of 12), 1% carboxymethylcellulose (6 of 12), fibrin sealant (4 of 9), and 2% carboxymethylcellulose (4 of 12). CONCLUSIONS: The efficacy of antiadhesion agents appears to be related to the agent's viscosity, ability to coat the wound surface, and residence time at the site of injury. In this rat model an agent that remained on the injured surfaces for at least 36 hours after injury appeared to be more effective in reducing adhesion formation than an agent with a shorter residence time.

Animals↗
PubMed1982

Colon volvulus and the geriatric patient.

One is tempted to believe that volvulus in elderly patients on many occasions may be preceded by inactivity and pseudomegacolon. Owing to psychiatric problems, chronic illness, or institutionalization, the patient is more likely to be subjected to treatment with sedatives and psychotropic drugs, causing decreased neuromuscular function of the gut. The basic principles in treating the volvulus are releasing the volvulus, deciding whether a nonoperative or an operative procedure should be employed, and treating complications. As far as surgical management is concerned, several techniques have been suggested, some of which are still controversial. Colonoscopy appears to have become an important method of treatment for volvulus with clearly established indications. Oddly enough, already hospitalized patients are occasionally subjected to delayed attention for volvulus. Therefore, physicians responsible for the care of geriatric patients should be alerted by even fairly mild symptoms of distention, abdominal pain, vomiting, and constipation. Clinical evaluation, including routine films of the abdomen, may avert a major catastrophe.

Activities of Daily Living↗
PubMed1984

Internal abdominal hernias.

Internal hernias are the underlying cause of acute or intermittent intestinal obstruction in approximately 4 per cent of cases. Their preoperative diagnosis depends on radiologic evaluation of the gastrointestinal tract with contrast material. This article presents the clinical and radiographic findings associated with various types of intra-abdominal herniations.

Cecal Diseases↗
PubMed2003

Etiology of cecal and hepatic lesions in mice after administration of gas-carrier contrast agents used in ultrasound imaging.

The aim of the study was to investigate the etiology of cecal and hepatic lesions in mice and rats after intravenous administration of gas-carrier contrast agents (GCAs). A modified fluorescein flowmetry technique and 24 h necropsy were used in mice (conventional and germ free), rats, and guinea pigs after GCA administration. Different diets and oral nonabsorbable antibiotics were used. Nonfluorescence, edema, congestion, hemorrhage, and mucosal erosion in cecum and colon and nonfluorescent areas in the liver were observed from 16 min after GCA administration in conventional mice on standard diet. Numerous gas bubbles (>50 microm) were observed in the vasculature around the nonfluorescent areas of cecum and colon and in mesenteric vessels draining to the portal vein. Acute inflammation, edema, hemorrhage, and ulceration of the cecum and colon and liver necrosis were seen 24 h after GCA administration in conventional mice on standard diet. When mice were maintained on either a diet with glucose as the only carbohydrate source or on a standard diet supplemented with antibiotics, uniform fluorescence and no organ lesions were observed after GCA administration. Uniform fluorescence and no organ lesions were observed in germ-free mice, rats, and guinea pigs dosed with GCAs and in control animals (mice, rats, and guinea pigs) dosed with sucrose. The results indicate that intravascular growth of GCA microbubbles occurs in the cecal and colonic wall of mice, leading to occlusive ischemia and necrosis in these intestinal segments and secondary gas embolisation in the liver. Transmural gas supersaturation in the cecal wall may explain the intravascular bubble growth in mice.

Albumins↗
PubMed1977

Mucocele of the appendix secondary to obstruction by endometriosis.

A mucocele of the appendix secondary to obstruction by endometriosis is reported and the relevant literature reviewed. The theories of the pathogenesis of appendiceal mucocele are reviewed and discussed. To our knowledge, no similar, well documented case has been reported.

Adult↗
PubMed1987

Diverticulosis of the vermiform appendix in patients with cystic fibrosis.

This paper presents a study of diverticulosis of the vermiform appendix in patients with cystic fibrosis. The records of two hospitals were reviewed. A total of 39 autopsy specimens and 18 surgical specimens were obtained. Diverticulosis of the appendix was found in 14 per cent (eight of 57) of all appendices. Two of these cases also showed diverticulitis. These results stand in contrast to the incidence of diverticulosis of the appendix in the general population, which has been measured at 1 to 2 per cent in various reviews.

Adolescent↗
PubMed1982

Angiodysplasia of the colon. Experience of 26 cases.

26 patients referred for colonoscopy with unexplained anaemia or blood loss per rectum were found to have angiodysplasia located in the caecum and/or ascending colon. All patients had undergone previous extensive investigation. After endoscopic photography of the lesions coagulation and biopsy were carried out in 23 patients. In 3 patients the extent of the lesion demanded surgical management, and right hemicolectomy was carried out without prior coagulation biopsy, 3 other patients underwent surgery at a later date-2 for further bleeding and 1 for complications of coagulation biopsy. Colonoscopy with photography and coagulation biopsy proved a safe and effective approach to the management of angiodysplasia in the majority of patients. It provided successful treatment and confirmation of the diagnosis without resort to major surgery, which in elderly patients is associated with high morbidity and mortality.

Aged↗
PubMed1989

Incidence and sonographic diagnosis of bacterial ileocaecitis masquerading as appendicitis.

533 consecutive patients with suspected acute appendicitis or appendiceal mass were examined by ultrasonography to distinguish acute appendicitis from bacterial enteritis. In 61 (11.4%) ultrasonography revealed the characteristic picture associated with bacterial enteritis of the ileocaecal region--enlarged mesenteric lymph nodes and mural thickening of the terminal ileum and caecum--but no image of the appendix. In 41 of these a bacterial infection was confirmed: infection due to Yersinia enterocolitica in 21, Campylobacter jejuni in 15, Salmonella B in 3, Salmonella C in 1, and Yersinia pseudotuberculosis in 1. In the other 20 bacteriological tests were negative (10) or not done (10). Oral barium studies, done in 15 patients, showed thickening of the terminal ileum in all of them. Only 22 of the 61 patients had diarrhoea. Yersinia enteritis clinically simulated an appendiceal mass in 17 of 22 patients, 6 of the 61 patients underwent surgery, and in all of them the appendix removed was normal. The other 55 patients recovered with conservative treatment. In 26 a planned appendicectomy was cancelled because of the sonographic findings. Bacterial enteritis limited to the ileocaecal region (bacterial ileocaecitis) seems to be responsible for an appreciable number of unnecessary appendicetomies. It has characteristic sonographic features that distinguish it from appendicitis.

Adolescent↗
PubMed1987

Enteropathogenicity of Treponema hyodysenteriae in young chicks.

Observation by scanning electron microscopy served to demonstrate that Treponema hyodysenteriae colonized the cecal mucosa of young chicks on day 3 after inoculation and produced lesions from 9 days after inoculation. Severe and clearly visible lesions were present on the cecal mucosa of all chicks necropsied 18, 21, and 24 days after inoculation. Severe lesions such as roughness of mucosal surface and disappearance of the mucosal foldings were observed at low magnification. The lesions were characterized by a destruction of superficial epithelial cells and dilation of crypt orifices. The dilated orifices of crypts were clearly observed, and the number of the crypts increased as compared with that of the crypts on the cecal surface in non-infected chicks. At high magnification, mucosal epithelial cells were found to be desquamated and the surface of the lamina propria mucosae had appeared. Numerous treponemas became visible on the surface of damaged epithelial cells and on the surface of the lamina propria mucosae.

Animals↗
PubMed2004

[Giant retroperitoneal cystic mass: appendiceal mucocele].

Appendiceal mucocele is a term used to describe the dilatation of the vermiform appendix produced by an intraluminal accumulation of mucus. Four pathological processes have been described that may lead to an appendiceal mucocele: obturation of cecoappendiceal communication, mucosal hyperplasia, mucinous cystadenoma and mucinous cystoadenocarcinoma. The most frequent is mucinous cystadenoma, seen in 50% of appendiceal mucoceles. 6% of patients with appendiceal mucocele develop peritoneal pseudomixoma, possibly through dissemination of the epithelial cells into the abdominal cavity. Preoperative diagnosis of the lesion is particularly important in order to deal with it carefully during surgery. CT scan is the most precise radiological exploration, although there are no pathognomonic signs of mucocele. Typical CT finding of a mucocele is a well-defined cystic mass that compresses the cecum without any peripheral inflammatory reaction, and with low levels of attenuation that vary between water and soft tissue density. We present a case of an appendiceal mucocele caused by a mucinous cystadenoma clinically presented as a giant retroperitoneal mass. Diagnosis was postoperatively made, after pathological study of the surgical sample.

Aged↗