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Anastomoses between the colic branch of the ileocolic artery and the right colic artery.
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Cow's milk as a cause of infantile colic in breast-fed infants.
18 mothers of 19 breast-fed infants with infantile colic were put on a diet free of cow's-milk protein. The colic disappeared promptly from 13; in 12, it reappeared on at least two further indirect challenges (in the form of a diet containing cow's milk to the mother). Most infants became symptom-free at age 2 to 4 months; at 4 months, only 4 reacted with colic when the mother took cow's milk. 5 infants were directly challenged with cow's milk; 4 reacted promptly with colic. Other signs of intolerance to cow's-milk protein developed in 3 infants during weaning. The treatment of infantile colic in breast-fed infants by a diet free of cow's milk for the mother appears worthwhile.
Renal colic and associated pyelorenal reflux as a cause of some diseases.
Renal colic always involves pelvic hypertension and severe urodynamic disturbances which result in fornical reflux, urine leakage to renal interstitial tissues, to tissues of the renal sinus, and sometimes to the retroperitoneal space. If the urinary tract is infected, renal colic may lead to acute pyelonephritis and generalized infection, as well as to bacteriemic shock. Of great importance in the origin of retroperitoneal fibrosis are fornical refluxes. Since renal colic is the most frequent cause of pyelorenal reflux, patients with renal colic should be promptly given appropriate treatment aimed at eliminating or at least lowering pelvic hypertension.
Gastro-colic fistula complicating benign gastric ulcer in analgesic abusers.
Two cases of gastro-colic fistula occurring in analgesic abusers are described. In both patients, the fistulous communication was diagnosed at endoscopy and subsequently verified by upper gastrointestinal tract barium studies. Gastro-colic fistula is a rare complication of benign peptic ulcer disease. Whilst salcylates and cortico-steroids have been implicated as aetiological agents, abuse of compound analgesics has not previously been reported. Since the first description of gastro-colic fistula in 1755, thirty documented cases associated with benign gastric ulcer have been reported. Most often, gastro-colic fistula occurs secondary to gastric or colonic malignancy. Barium enema examination is the most accurate diagnostic study. Endoscopy has been confined to the visual inspection of the ulcer and establishing the benign nature of these lesions.
Glucagon, ureteral colic and ureteral peristalsis.
Experimentally, glucagon is an effective ureteral relaxant that induces a moderate diuresis. Our data suggest that in specified cases of ureteral colic, before the development of a ureteral bar, flaccid dilatation of the pelvis and renal shutdown, glucagon may facilitate the expulsion of small ureteral calculi. When the ureteral pain is due to hyperperistalsis the drug has promise in the alleviation of pain. The complexities of the pathophysiology of ureteral colic in an experimental model support the treatment of ureteral edema in colic with anti-inflammatory drugs but suggest certain precautions in the design of any investigation of drug therapy for colic, lest a good drug be found ineffective for the wrong reason-that it was used in an impossible situation.
Causes of colic and types requiring surgical intervention.
The migration of strongyle larvae is the most common or basic underlying cause of colic in the horse. Disease conditions producing symptoms of colic occur in all sections of the intestinal tract and consist of impactions, torsions, herniations and foreign bodies. Colic also occurs as a result of pre- and post-partum diseases such as torsion of the uterus, haemorrhage, rupture and inversion of the uterus. In general, lesions resulting in circulatory obstruction are the types requiring surgical intervention. There are six general types of small intestine obstruction that lend themselves to surgical treatment; namely, volvulus, herniations, intussusceptions, stenosis of the lumen of the bowel by external bands or by foreign bodies and chronic inflammatory lesions. The large intestine is not subject to the variety of obstructive lesions found in the small intestine. Impactions count for a large percentage of the obstructions seen. A standing laparotomy for diagnostic purposes may be indicated. Small colon impactions are readily treated by standing laparotomy. Enteroliths are of very common occurrence in some areas of the country; they often result in rupture of the colon. Torsions of the colon produce septic shock very rapidly. The left dorsal colon moving medially or laterally and ventrally initiates the torsion. Clockwise rotation is most common. Massive intravenous therapy is needed to maintain hydration. Ventral midline laparotomy gives best access. Surgery must be performed very early to avoid massive tissue necrosis. Survival rate is 30 percent or less. The small colon is also capable of rotation and volvulus, and of strangulation in the umbilical or inguinal ring.
Cube colic.
"Cube colic" is described and vain attempts to cause the problem on an experimental basis are recorded. It is concluded that not all horses are susceptible to cube colic and if colic occurs in horses being fed on cubes, it is not necessarily due to feeding of cubes. Nomenclature of bowel disorders is considered.
[The effect of the combination pramiverine/metamizole in colic pain (author's transl)].
A combination of 4,4-diphenyl-N-isopropyl-cyclohexylamine-hydrochloride (pramiverine, Sistalgin) and N-methyl-N-(2,3-dimethyl-5-oxo-1-phenyl-3-pyrazolin-4-yl)-aminomethanesulfonate (metamizole) (Sistalgin comp.) was injected in 250 patients with severe colic pain. In 94% of the cases prompt relief from pain was observed. In addition to the reliable effect in colics of the gastrointestinal tract and the biliary duct, the high rate of success in colics of the urinary tracts should be mentioned. Good therapeutic results were also observed in pancreatitis. Only isolated cases of slight undesirable anticholinergic concomitant effects were noted. There was no effect on blood pressure and pulse rate.
The cholecysto-colic relationships. A roentgen-anatomic study of the colonic manifestations of gallbladder disorders.
In approximately 80 per cent of cases the gallbladder is closely applied to the superior medial aspect of the right colic flexure. This intimate anatomic relationship provides pathways for direct extension of both inflammatory and neoplastic lesions of the gallbladder to involve the adjacent colon. The resultant secondary colonic abnormalities noted in 15 patients have been analyzed and correlated with surgical-pathologic findings. In acute cholecystitis, barium enema examination shows evidence of indentation by an enlarged gallbladder, spasm and mucosal edema in the anterior hepatic flexure. Chronic cholecystitis results in involvement of the adjacent colon by fibrous adhesions and inflammatory reaction. These may further lead to the development of pseudotumors simulating primary carcinoma of the colon. Similar findings including cholecysto-colic fistulae may be the initial manifestations of carcinoma of the gallbladder. The spectrum of pathologic-roentgenographic alterations in the cholecysto-colic interface is described and illustrated. Recognition of these features is of critical importance for the correct interpretation of barium enema findings and the subsequent management of patients with gallbladder disorders.
The failure of conventional drug therapy in the management of infantile colic.
During five years, 97 young infants with colic were studied. One of us (J. C. O'D.) compared homatropine methylbromide plus phenobarbital in a 20% alcohol solution, and all of the individual components of that solution, to see which was most effective in the symptomatic relief of colic. Regardless of the child's age on entry into the study, conditions in no treatment group improved more rapidly than in those treated with a placebo.
Butorphanol and meperidine compared in patients with acute ureteral colic.
Pain relief was evaluated in 81 patients with acute ureteral colic and the confirmed presence of a calculus. A randomized double-blind comparison of intramuscular 2 and 4 mg. butorphanol and 80 mg. meperidine was used. Pain intensity and pain relief were evaluated at half hour and hourly intervals for 4 hours. A 2 mg. dose of butorphanol was found to be analgesically equivalent to 80 mg. meperidine, while a 4 mg. dose of butorphanol was found to be more effective than 80 mg. meperidine and 2 mg. butorphanol. Each patient received up to 2 doses of analgesic medication when necessary. There was no significant difference in the incidence of side effects among treatments. One patient had visual hallucinations after a 2 mg. dose of butorphanol, possibly owing to its antagonistic activity to significant narcotic experience given previously at another hospital. There was no other evidence of toxicity with butorphanol. It was found to be a safe, effective and wall tolerated drug for the treatment of ureteral colic and is recommended in place of narcotics.
Weather and the incidence of urinary stone colic.
There were 204 patients in one specific district with renal colic who were studied to determine the relationship of the condition to climatic conditions. It was found that stones were prone to cause colic on warm days when air pressure was falling.
Clinical evaluation of blood lactate levels in equine colic.
Blood lactate levels were evaluated in 36 horses (43 cases) presented with colic. A correlation between increasing blood lactate levels and decreasing percentage survival has been shown. An appreciable anion gap was found in 7 of 10 cases analyzed in detail but in each case the entire gap could not be accounted for by lactate alone. Proposals are offered to account for the unmeasured anions. Blood lactate determination is suggested as a prognostic rather than a diagnostic aid for the equine practitioner and should be used to augment other clinical findings in the horse exhibiting colic.
[Myotropic spasmolysis in the treatment of ureteric colics (author's transl)].
The effectiveness of parasympathicolytic drugs in the treatment of ureteric colics is doubtful. Bencyclane is a new myotropic substance. Its spasmolytic effect on smooth muscle is five times stronger than that of papaverine. The results of the clinical use of Bencyclane in cases of ureteric colic are described and discussed.
Epidemiology of urinary stone colic.
Epidemiological study of urinary stone colics was done for 5 years in a defined basin located in the center of Japan. It was 2.5 times more frequent in males than in females. The difference was observed only in the age over 30 years. Recurrence occurred in 24.5% of the cases. Climatic factors were also analysed. The incidence was significantly high in summer and low in autumn. Days of decreasing air pressure and high temperature were frequently associated with stone colic.
[Reversible hyperuricemia in case of ureteral colics (author's transl)].
On about one fourth of the patients ureteral colics caused by oxalate and phosphate calculi lead to a reversible hyperuricemia. This result seems to be important, because we might wrongly diagnose a uric acid calculus. The reason for hyperuricemia is a temporary diuretic disturbance of the uric acid. It cannot be explained by the functional loss of the obstructed kidney, because a nephrectomy does not change the uric acid level. As a possible reason we suppose a ketose by food deficiency and vomiting caused by renal colic.
Torsion of the uterus--a cause of colic in the mare.
A case of uterine torsion in a mare with colic is described in which an early diagnosis was made and the torsion successfully reduced through a standing laparotomy with survival of both the mare and the foal. This case is used to stress the importance of thorough examination of all pregnant mares with colic in order to differentiate uterine torsion from other causes of abdominal pain, thereby avoiding delay in surgical correction and reducing the risk of fetal and/or maternal death. The advantages of the standing laparotomy are presented in support of this method of treatment of torsion of the gravid uterus.