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At least 145 records · Page 8Linked to original sources
PubMed1998

Congenital short bowel syndrome associated with appendiceal agenesis and functional intestinal obstruction.

Congenital short bowel with functional intestinal obstruction and absence of appendix vermiformis is a very rare condition with poor prognosis. Seventeen cases of congenital short bowel have been reported previously in the literature. The etiology is unknown. In this report, a case of congenital short bowel, combined with functional intestinal obstruction, mal-rotation, and absence of the appendix vermiformis, is presented and the pathogenesis discussed.

Appendix↗
PubMedDate not supplied

Morbidity and mortality due to Ascaris-induced intestinal obstruction.

We examined epidemiological aspects of Ascaris-induced intestinal obstruction (AI-IO) through analysis of published reports on the subject. In 9 studies of > or = 100 patients admitted to hospital due to ascariasis, intestinal obstruction was the single most common complication and accounted for 38-87.5% of all complications (weighted mean 72%). The proportion of intestinal obstruction caused by ascariasis was identified in 14 studies from 7 countries with varying degrees of endemic ascariasis. Using relevant data on the duration of the study, the number of beds in the reporting hospital, and the number of hospital beds/1000 population in the area, the number of cases of AI-IO/year/1000 population was estimated from 11 studies. Both the proportion of AI-IO (range 0-0.71) and the number of cases of AI-IO/year/1000 population (range 0-0.25) were significantly related, in a non-linear manner, to the local prevalence of ascariasis (range 0.01-0.92). In 12 studies of > or = 30 patients with AI-IO, the case fatality rates ranged from 0 to 8.6% (weighted mean 5.7%). The mean age of patients with AI-IO was < or = 5 years in 6 of 7 studies in which age was specified.

Adolescent↗
PubMed2005

Spectrum of causes of intestinal obstruction in adult Nigerian patients.

OBJECTIVE: To present changes in the cause of intestinal obstruction in an African setting. DESIGN: Consecutive cases of acute intestinal obstruction from 1985 to 1994. SETTING: Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. SUBJECTS: Adult patients with clinical and radiological evidence of intestinal obstruction. RESULTS: There were 99 patients (60 males) aged 15 - 101 years (mean age 45 years). The majority of patients were young and middle-aged adults. Main causes of obstruction included adhesion (N = 44), volvulus (N =15), external hernias (N = 11), colorectal carcinoma (N = 10) and intussusception (N = 8). Approximately two-thirds of patients (28/44) with adhesion had had previous abdominal operations. The overall mortality was 14%, mainly owing to strangulation obstruction and colonic malignancy. CONCLUSIONS: The increasing role of adhesions as a cause of acute intestinal obstruction demands greater need for routine preventive measures against adhesion formation.

Adult↗
PubMed2000

Management of intestinal obstruction in the patient with ovarian cancer.

Intestinal obstruction in the patient with ovarian cancer is a difficult situation for both patient and physician. In women presenting with ovarian cancer, obstruction is almost never complete. These women should undergo aggressive bowel surgery only if it is part of an optimal surgical cytoreduction. Women known to have ovarian cancer who develop intestinal obstruction have a poor prognosis: Few will live more than a year from the time of obstruction. Some, however, have an excellent performance status, and would be relatively unimpaired were it not for their obstruction. These women, who usually have a discrete obstruction and still display some response to chemotherapy, may benefit from surgical correction of the obstruction. Women who are not candidates for surgery can be effectively palliated pharmacologically so that they are comfortable with the obstruction, often without intestinal drainage. Algorithms are available to assist in the management of ovarian cancer patients with obstruction, but ultimately the treatment decision rests with the patient. The oncologist must use his or her knowledge and clinical judgment to help the patient develop an appropriate, individualized plan.

Algorithms↗
PubMed1996

Intestinal obstruction in a Saudi Arabian population.

In a six-year period, fifty-six cases of intestinal obstruction seen and treated at Asir Central Hospital since its inception were analysed. Adhesions from previous laparotomy scar constituted the commonest cause of intestinal obstruction (57.1%). A distant second is faecal impaction (7.1%). Previously performed appendicectomy is the commonest cause of adhesions causing intestinal obstruction. The interval between surgery and intestinal obstruction varies from one month to three years. The pattern of intestinal obstruction seen in this environment is more similar to those in the western World or advanced countries, than the pattern in the developing countries. This can be explained on the basis of the fact that, even though Saudi Arabia is a developing country, the health care delivery system is similar to those in developed countries. Fifty percent of intestinal obstruction due to adhesions were managed successfully by conservative treatment only. About 15% had a failed conservative treatment and had to undergo operation. In those cases that required exploration and lysis of adhesions, 43.8% also required bowel resection and re-anastomosis.

Adolescent↗
PubMed1979

Intestinal obstruction in neonates: causes of death.

Infectious complications such a peritonitis, septicaemia and pneumonia are the most important factors causing postoperative death in surgery of intestinal obstruction in children. In a series of 237 patients with intestinal obstruction with 21 fatalities, the percentage of deaths due to infection was 85.7%. In 1967 to 1976, 259.301 children died in Germany, among them 1541 suffering from intestinal obstruction (0.6%); that means 3.1% of the 49.540 patients who died of intestinal obstruction were children. The mortality of intestinal obstruction in infancy and childhood had fallen to one third of the original during this period, but the mortality in newborn infants fell only by 50%. This correlates with the decreasing birth rate, so that the lower death rate due to intestinal obstruction seems to be explained by a lower number of neonates. The literature shows that relative mortality (20%) from intestinal obstruction in the newborn has, however, remained constant during the last 20 years.

Bacterial Infections↗
PubMed2004

C-reactive protein may be a marker of bacterial translocation in experimental intestinal obstruction.

BACKGROUND: C-reactive protein (CRP) is used as a marker of intestinal ischaemia. This study evaluated whether CRP levels can be used to detect ischaemia-induced (strangulated) intestinal obstruction and subsequent bacterial translocation. METHODS: Forty-eight rats, divided into four groups underwent the following procedures: anaesthesia alone (native controls), laparotomy (sham-operated controls), or surgical induction of simple or strangulated intestinal obstruction (simple and strangulated obstruction groups, respectively). Blood samples were collected for culture and serum CRP analysis. In addition, liver and mesenteric lymph node (MLN) specimens were collected for culture, to determine the presence of bacterial translocation; and ileal segments, for histopathological investigation. RESULTS: CRP levels and rates of bacterial translocation, expressed as colony forming units (cfu) per gram wet tissue, were higher in both intestinal obstruction groups than in the native and sham-operated control groups (P < 0.001 for both). The increases in CRP levels paralleled increases in the number of cfu in the MLN and liver cultures (P < 0.01). Compared to controls, animals in the obstruction groups also had a higher incidence of positive blood cultures (P < 0.005) and greater histopathologic evidence of inflammatory infiltration of the lamina propria (P < 0.01). However, no significant difference between the simple and strangulated obstruction groups was observed. CONCLUSION: CRP levels increase with the severity of bacterial translocation in acute intestinal obstruction but do not permit discrimination between simple and strangulated intestinal obstruction.

Animals↗
PubMed2004

The epidemiology and treatment patterns of postoperative adhesion induced intestinal obstruction in Varsinais-Suomi Hospital District.

BACKGROUND AND AIMS: The epidemiology and treatment patterns of postoperative adhesion induced intestinal obstruction have been poorly investigated in Finland. This study evaluated the epidemiology and treatment patterns of postoperative adhesion induced intestinal obstruction in a well defined geographical area (Hospital District). MATERIAL AND METHODS: All inpatient episodes between 1.1.1999 and 31.12.1999 due to postoperative adhesion induced intestinal obstruction in Varsinais-Suomi Hospital District were evaluated retrospectively using individual patient records. RESULTS: 123 hospitalizations due to postoperative adhesion-related intestinal obstruction were observed during the study period. The total number of preceding operations was 176 considering altogether 101 patients. The most prevalent single initial operations causing adhesion induced intestinal obstruction were colorectal, upper abdominal, and female reproductive system procedures. Of all treatment episodes 32% were operative and mortality was 2%. The median days of hospital stay (range) of all inpatient episodes, operative episodes, and conservative episodes were 6 (1-58), 11 (2-34) and 4 (1-58), respectively. Patient dependent factors associated with increased likelihood to operative treatment of obstruction were: female gender (40% in females vs 23% in males, P = 0.042) and previous gynaecological surgery (70% of the patients, P = 0.032). Intraoperative findings were obstruction in 70%, strangulation in 20%, necrosis in 8%, and perforation in 2% of operations. Bowel resection was needed in 38% of operations. Preceding gynaecological surgery increased the likelihood of bowel strangulation as an intraoperative finding. CONCLUSION: The epidemiology, treatment patterns and results of postoperative adhesion induced intestinal obstruction are of the average international level in the Varsinais-Suomi Hospital District. The treatment patterns among the different hospitals in the Hospital District are similar. Female gender is associated with increased risk for operative treatment of adhesive obstruction. Previous gynaecological surgery increases the likelihood of operative treatment and complicated obstruction.

Adult↗
PubMed1991

[Changes in vasoactive intestinal polypeptide levels in intestinal obstruction and the influence of da cheng qi decoction].

The role of vasoactive intestinal polypeptide (VIP) in small intestine obstructed rabbits and the therapeutic mechanism of Da Cheng Qi Decoction (DCQD) were studied. VIP concentrations of both blood and intestinal tissue were measured by specific radio-immunoassay in a rabbits' mechanical small intestinal obstruction model using fix of ileum to the right low abdominal wall, the influences of duodenal perfusion of DCQD on VIP levels were also investigated. 24 hours after ligating ileum, VIP of arterial plasma was elevated 7 fold, reaching 138.65 +/- 25.58 pmol/L, that of portal vein plasma was 4 times of the arterial value. VIP immunoactivity was detected in peritoneal fluid. VIP content of duodenal tissue in 16 intestine obstructed rabbits was 2 times high as that in 15 controls, whereas that of colonal tissue was inversed. DCQD caused a 50% decrease of elevated plasma VIP in experimental animals and a 65% increase in controls. The present work demonstrates that VIP might be released into the portal and peripheral circulation and mediate local and systemic pathophysiologic alterations accompanying small intestinal obstruction, such as hyperemia and edema of intestinal wall, accumulation of fluid in the lumen. VIP changes might account for the redistribution of blood flow in the obstructed segment of small intestine and the distal site of obstruction. DCQD has a therapeutic effect. The mechanism of dual modulate action of DCQD on VIP concentration is beyond our knowledge.

Animals↗
PubMed2005

Intestinal obstruction in patients with previous laparotomy for non-malignancy.

BACKGROUND: Intestinal obstruction is one of the most common surgical emergencies. The aim of this study was to identify important management information from the evaluation of patients with intestinal obstruction who had undergone previous laparotomy for non-malignancy. METHODS: Data from 176 patients with previous laparotomy for non-malignancy, and who were operated on for intestinal obstruction, were collected and analyzed retrospectively. RESULTS: Gastroduodenal operations, appendectomy, and obstetric/gynecologic procedures were the 3 most common previous abdominal surgeries. More than half of all bowel obstructions developed within 10 years after previous laparotomy, and particularly within the first 5 years. Most obstructions were related to adhesion, although their etiologies were diverse. The rate of bowel strangulation was much higher in patients with internal herniation, volvulus, intussusception, closed loop, and diaphragmatic hernia than in patients with simple adhesion, bezoar, tumor, and inflammation (48.3% vs 12.2%). The surgical mortality rate correlated significantly with bowel strangulation: the overall rate was 6.8%, that in patients with strangulation was 18.8%, and that in patients without strangulation was 4.2%. CONCLUSION: The etiologies of intestinal obstruction were not only significantly related to bowel strangulation, but were also an important determinant of therapeutic strategy.

Adult↗
PubMed2001

Contrast radiography in small intestinal obstruction, a valuable diagnostic tool?

OBJECTIVE: To investigate the diagnostic and therapeutic potential of plain abdominal radiographs and contrast radiography in patients with suspected small intestinal obstruction. DESIGN: Retrospective study. SETTING: General hospital, Sweden. MATERIAL: 2357 sets of plain abdominal radiographic casenotes. MAIN OUTCOME MEASURES: Analysis of plain abdominal radiographs for small intestinal obstruction. Establishment of the time that subsequent contrast radiography medium took to reach the caecum, and its success rate. RESULTS: Of the 2357 plain abdominal films 1599 (68%) did not show small intestinal obstruction, 425 (18%) showed intermediate obstruction, and 333 (14%) showed small intestinal obstruction. The water-soluble contrast medium reached the colon in 394/591 (67%) of the cases with intermediate or complete small intestinal obstruction. Although the contrast medium passed to the colon there was remaining abnormality with dilated small intestine in 71/212 (33%) of the cases with intermediate obstruction and in 95/143 (66%) of the small intestinal obstruction group. The time for the contrast medium to reach the colon was 3.4 hours in the normal group, 5.5 hours in the intermediate group and 8.9 hours in the obstruction group. CONCLUSION: The plain abdominal radiographs seem to predict the success of follow-through examinations. Contrast radiography is safe and may have a therapeutic potential in small intestinal obstruction.

Acute Disease↗
PubMed1986

[Rare forms of acute intestinal obstruction].

The article analyzes 31 cases of rare forms of acute intestinal obstruction (nodulation and invagination of the intestine, obturation of the small intestine by bile stones and bezoars). Their incidence as compared with all the cases of intestinal obstruction of non-tumor etiology was from 1.0 to 3.3%. These diseases are difficult for diagnosis prior to operation and have different clinical manifestations. The surgeon's tactics should be differentiated and dependent on intraoperative findings. The syndrome diagnosis (intestinal obstruction, peritonitis) and early operation in such diseases are thought to be the correct tactics.

Acute Disease↗
PubMed1985

Closed loop intestinal obstruction due to vitello-intestinal remnants.

Two young children presented with acute small bowel obstruction associated with closed loop ileal obstruction caused by Meckel's diverticulum and vitello-intestinal duct remnant respectively. In each, resection of the vitelline remnant and ischaemic ileum with primary small bowel anastomosis resulted in good recovery.

Child, Preschool↗
PubMed1977

[Regional redistributions of the blood in high and low small intestine obstruction].

In the experimental model of high and low obstruction of the small intestine during 24 hours the authors observed considerable shifts in electrolytic blood content. Total amount of circulating blood, compared with control (laparotomy), was not changed. These data allowed a new consideration of the entity of the pathological syndrome in intestinal obstruction.

Animals↗
PubMed1989

[Prenatally diagnosed intestinal obstruction--contribution of pediatric surgery].

The diagnosis of a small intestinal obstruction was made prenatally between the 31st and 36th week of pregnancy in 7 patients with neonatal ileus. Five newborns showed a meconium-peritonitis, a meconium-ileus and the last a ileal atresia. These were compared with newborns with small intestinal obstruction, which had not been diagnosed prenatally. The analysis of our hospital information indicates, that primarily serious forms of ileus and intestinal perforations are diagnosed prenatally, whilst isolated small intestinal obstruction often avoids diagnosis. For this reason, diagnostic punctation of the foetal abdomen contribute little to the establishment of the etiology of the obstruction and should be avoided. On the other hand, punctation of a foetal ascites can, through pressure reduction of the abdomen, lengthen the duration of pregnancy and permit a spontaneous birth.

Adult↗