• In small-bowel obstruction imaging, certain radiologic investigations can be used to confirm the diagnosis and severity of the obstruction, but not its etiology. (medscape.com)
  • this caused the small-bowel obstruction. (medscape.com)
  • The clinical diagnosis was small-bowel obstruction resulting from adhesions. (medscape.com)
  • This plain abdominal radiograph of a 55-year-old woman presenting with features of intestinal obstruction shows dilated loops of the small bowel associated with thickened edematous valvulae conniventes and a strangulated left inguinal hernia (arrow). (medscape.com)
  • A CT scan of a 36-year-old woman with Gardner syndrome presented with features of small-bowel obstruction. (medscape.com)
  • Do not use oral contrast in patients with suspected small-bowel obstruction. (medscape.com)
  • A transition zone is required for the diagnosis of small-bowel obstruction. (medscape.com)
  • CT of the abdomen and pelvis with IV contrast is usually appropriate for the initial imaging of a suspected small-bowel obstruction with an acute presentation. (medscape.com)
  • Atri et al studied 99 adult patients who underwent 105 nonenhanced CTs and enhanced CTs and found that the 2 procedures had comparable accuracy in diagnosing mechanical small-bowel obstruction and that they can be interpreted by reviewers of varying expertise. (medscape.com)
  • O'Daly et al conducted a retrospective review of 88 patients who had acute adhesional small-bowel obstruction and underwent CT, and 58 (66%) were managed conservatively and 30 (34%) underwent surgery. (medscape.com)
  • So every patient who shows up with a bowel obstruction should have surgery, to prevent ischemic complications, right? (crashingpatient.com)
  • First off, the traditional terminology used to classify bowel obstruction probably should be discussed. (crashingpatient.com)
  • Partial bowel obstruction describes a patient who has dilated bowel on imaging, has nausea and vomiting, but continues to pass flatus or even stool intermittently. (crashingpatient.com)
  • Let me say a quick word about the pathophysiology of bowel ischemia in the setting of bowel obstruction. (crashingpatient.com)
  • On a very basic level, and obstruction that results in, or is caused by, twisting of the mesenteric vasculature (volvulus, internal hernia, or adhesion-related mesenteric restriction) can, and often does, result in ischemic bowel. (crashingpatient.com)
  • As an obstruction progresses, the bowel proximal to the point of obstruction becomes progressively more dilated over time as the succus and GI secretions accumulate. (crashingpatient.com)
  • This latter type of bowel ischemia is the reason behind the traditional dictum in surgical training to "Never let the sun rise or set on a complete bowel obstruction. (crashingpatient.com)
  • Dr. Martin Zielinski led a group of providers to create and prospectively validate a model to predict ischemic bowel obstruction. (crashingpatient.com)
  • The team showed that three signs are associated with an ischemic obstruction: obstipation (no flatus or stool for 24 hours), mesenteric edema on CT scan, and absence of small bowel feces sign on CT. (crashingpatient.com)
  • It has been reported in many non-fatal conditions, such as inflammatory bowel disease, intra-abdominal abscess, bowel obstruction, paralytic ileus, endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy, and gastric dilatation. (e-jyms.org)
  • A closed-loop obstruction occurs when inflow to the loop of bowel and outflow from the loop are both blocked. (basicmedicalkey.com)
  • Compromised blood flow to the bowel causing ischemic necrosis is referred to as strangulated obstruction. (dermatologyadvisor.com)
  • The proximal small bowel is normally relatively sterile, but with a high grade or complete obstruction, bacterial overgrowth with anaerobes such as Bacteroides may result in feculent vomiting. (dermatologyadvisor.com)
  • but currently in the Western world, adhesions have become the most frequent cause of adult small bowel obstruction, accounting for 74% of cases in a series by Miller. (dermatologyadvisor.com)
  • The most frequent etiology of bowel obstruction varies by age. (dermatologyadvisor.com)
  • 60.0% due to complications of peritoneal disease, most commonly intestinal obstruction (I/O). 14.3% required emergency surgery for I/O and 23.8% required abdominal cope loop and ureteric stent insertion. (medicinelakex1.com)
  • On the radiograph an obstruction can only be diagnosed if the bowel has had sufficient time to become air-filled after birth. (radiologyassistant.nl)
  • [ 1 ] Conventional plain radiography (see the images below) is the investigation of choice for patients with suspected small-bowel obstructions. (medscape.com)
  • But how reliably can a surgeon categorize bowel obstructions as complete or partial? (crashingpatient.com)
  • In one study, more than 50% of bowel obstructions with ischemia were misdiagnosed. (crashingpatient.com)
  • Examples of closed-loop obstructions are torsion of a loop of small intestine around an adhesive band ( Fig. 49-2 ), incarceration of the bowel in a hernia, volvulus of the cecum or colon, or development of an obstructing carcinoma of the colon with a competent ileocecal valve. (basicmedicalkey.com)
  • In this article we will discuss the congenital gastrointestinal obstructions and also some acquired diseases that present as an acute abdomen in the neonate. (radiologyassistant.nl)
  • SBO can also be caused by small intestinal tumors such as carcinoid, lymphoma, and small bowel adenocarcinoma. (dermatologyadvisor.com)
  • BACKGROUND: Comprehensive genomic analysis has shown that small bowel adenocarcinoma (SBA) has different genomic profiles from gastric and colorectal cancers. (bvsalud.org)
  • Most cases of HPVG are historically related to mesenteric ischemia accompanied by bowel necrosis. (e-jyms.org)
  • If necrosis progresses to all layers of the bowel, perforation is inevitable. (dermatologyadvisor.com)
  • Bowel necrosis may also result from direct compression of the blood supply, as can be seen with volvulus or with a tight hernia ring. (dermatologyadvisor.com)
  • Signs of bowel ischemia such as pneumatosis, portal venous gas, or pneumoperitoneum should prompt urgent surgical evaluation. (medscape.com)
  • We performed a retrospective review of a prospectively maintained database of 34 patients who underwent CRS and HIPEC and 21 patients who underwent PC for CLR peritoneal carcinomatosis, at the National Cancer Centre Singapore (NCCS), from Jan 2008 to Dec 2013. (medicinelakex1.com)
  • Consider the risk of contrast-induced nephropathy in patients with chronic kidney disease. (medscape.com)
  • He identified periodic acid-Schiff (PAS)-staining granules, most likely representing degenerating bacterial forms, within macrophages isolated from the small bowel as well as other tissue and fluid specimens (eg, pericardium, endocardium, lymph nodes, synovia, lung, brain, meninges) obtained from patients in whom Whipple disease was suspected. (medscape.com)
  • Patients with a long history of recurrent abdominal pain and who on imaging were found to have a diffusely thickened gall bladder wall, with cholelithiasis, choledocholithiasis and submucosal hypoattenuated nodules were likely to have XGC while those with anorexia,weight loss,focal thickening of the gallbladder wall on imaging and dense local organ infiltration were more likely to have GBC. (medicinelakex1.com)
  • Cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy (HIPEC) provide prolonged survival in selected patients with colorectal (CLR) peritoneal carcinomatosis. (medicinelakex1.com)
  • CRS and HIPEC confer prolonged survival compared to PC in patients with CLR peritoneal carcinomatosis. (medicinelakex1.com)
  • Patients treated with palliative chemotherapy suffer significant morbidity from disease progression that disrupts chemotherapy and results in significantly longer hospitalization. (medicinelakex1.com)
  • Peritoneal fluid detected on a CT scan was identified as an independent predictor of surgical intervention. (medscape.com)
  • When a loop of bowel becomes obstructed, intestinal gas and fluid accumulate. (basicmedicalkey.com)
  • Transudative fluid is lost into the peritoneal cavity. (dermatologyadvisor.com)
  • Healthy bowel can tolerate an impressive amount of dilation provided that such dilation occurs gradually . (crashingpatient.com)
  • If the bowel is not healthy (history of IBD, prior surgery, radiation, etc.), or if the dilation happens quickly, the luminal pressures exceed the perfusion pressure of the intestinal capillary network, and blood flow stops. (crashingpatient.com)
  • As dilation worsens, bowel wall edema develops, leading to deranged absorptive mechanisms, further exacerbating the increased luminal pressure. (dermatologyadvisor.com)
  • When signs of peritoneal irritation or frank peritonitis develop, there is a high level of suspicion that the viability of the bowel is compromised. (basicmedicalkey.com)
  • We hypothesize that PC is suboptimal due to complications arising from peritoneal disease that disrupts chemotherapy. (medicinelakex1.com)
  • Secondary outcomes of frequency of chemotherapy disruptions, need for invasive interventions, and duration of hospitalization for complications of peritoneal disease were evaluated. (medicinelakex1.com)
  • This article, besides being a general presentation of Whipple disease, focuses on both the neurologic manifestations and specifics of diagnosis and treatment of Whipple disease with symptomatic CNS involvement (CNS-WD). (medscape.com)
  • 1947: Peroral small bowel biopsy was used for the first time to make the first reported premortem diagnosis. (medscape.com)
  • 1949: Black-Schaffer advanced the diagnosis, proved the systemic nature of this disease, and raised the suspicion of an infectious cause for Whipple disease. (medscape.com)
  • OS was calculated from the date of diagnosis of peritoneal metastases till death. (medicinelakex1.com)
  • Hepatic portal venous gas (HPVG) is a rare radiographic finding associated with severe intra-abdominal disease and fatal outcome. (e-jyms.org)
  • In later stages, increased venous pressure in the bowel wall can result in hemorrhage into the lumen, worsening hypovolemia and further increasing intraluminal pressure. (dermatologyadvisor.com)
  • The hallmark of the pathologic report was the marked infiltration by foamy macrophages of joints and aortic valves, and prominent deposits of fat within intestinal mucosa and mesenteric lymph nodes, which made Whipple consider this case an obscure disease of fat metabolism and propose the name intestinal lipodystrophy. (medscape.com)
  • The axial contrast-enhanced CT scan through the midabdomen shows an extrinsic mass compressing a loop of small bowel. (medscape.com)
  • The current spread of computed tomography scan promotes not only the early detection of related severe diseases but also the identification of other causes of HPVG. (e-jyms.org)
  • It is characterised by normal endoscopic appearances, microscopic features of colonic inflammation and thickening of the sub epithelial collagen layer. (passmed.uk)
  • The abdominal radiograph shows dilated loops of small bowel, but the concentration of several loops of small bowel in the right hypochondrium should be noted as this finding is suggestive of malrotation. (medscape.com)
  • This radiograph shows markedly distended loops of small bowel, with effacement of the valvulae in the mid abdomen. (medscape.com)
  • On the left image the bowel is dilated and the diameter exceeds L2 interpedicular width in a patient with meconium ileus. (radiologyassistant.nl)
  • 1952: Paulley was first to report a case of a patient with histologically proven Whipple disease whose symptoms responded to chloramphenicol. (medscape.com)
  • Chemotherapy treatment is however often accompanied by serious side-effects, and the identification of biomarkers for early prediction of disease and treatment-associated symptoms could help alleviate patient suffering. (bvsalud.org)
  • The loops of the small bowel are dilated, and associated with small calcific nodules in the right iliac fossa are seen. (medscape.com)
  • Despite the slowly progressive course of most cases of Whipple disease, CNS-WD may have a fulminant course, and manifest isolated CNS-WD cases have been reported in the literature. (medscape.com)
  • CD8-high was significantly associated with less lymph node metastasis (P = 0.047), less distant metastasis (P = 0.024), less peritoneal dissemination (P = 0.034), and earlier TNM stage (P = 0.047). (bvsalud.org)
  • Histologic analysis reveals a thickened sub apical collagen layer and increased lymphocytes in the lamina propria. (passmed.uk)
  • They used a gene that encodes for 16S ribosomal RNA (rRNA) in bacteria to characterize the nucleotide sequence of the bacillus from a patient with Whipple disease. (medscape.com)