Search results for "Obstruction"
showing 10 items of 260 documents
Clinical strategies for the management of intestinal obstruction and pseudo-obstruction. A Delphi Consensus study of SICUT (Società Italiana di Chiru…
2016
Intestinal obstructions/pseudo-obstruction of the small/large bowel are frequent conditions but their management could be challenging. Moreover, a general agreement in this field is currently lacking, thus SICUT Society designed a consensus study aimed to define their optimal workout.The Delphi methodology was used to reach consensus among 47 Italian surgical experts in two study rounds. Consensus was defined as an agreement of 75.0% or greater. Four main topic areas included nosology, diagnosis, management and treatment.A bowel obstruction was defined as an obstacle to the progression of intestinal contents and fluids generally beginning with a sudden onset. The panel identified four major…
Paraduodenal hernia: an uncommon cause of recurrent abdominal pain.
2004
Internal abdominal hernias are a rare entity and may cause unexplained abdominal pain. This report concerns a 46 year old male patient, with a four year history of episodic colicky peristaltic abdominal pains, in whom a left paraduodenal hernia was found at surgical exploration after a negative diagnostic screening by ultrasound, CT and small bowel enema. Upon laparotomy the Authors found a left-sided paraduodenal hernia with an empty herniated sack. Repair of the hernial defect resulted in the complete and stable resolution of abdominal symptoms. The importance of considering paraduodenal hernias in the differential diagnosis of unexplained intermittent abdominal pain is discussed.
The control of lava flow during the 1991–1992 eruption of Mt. Etna
1993
Abstract All the actions carried out in 1992 to protect the village of Zafferana Etnea from being invaded by lava are described. An earthen barrier 234 m long and 21 m high was firstly built in January 1992 by accumulating with mechanical escavators 370,000 m 3 of earth, scoriae and stones. This embankment contained the lava for about one month and was overflowed by April 9, 1992. Three additional smaller earthen barriers (lenght: 90–160 m; height: 6–12 m) were built in April to gain time while the lava front was descending towards Zafferana from the overflowed first embankment. The major effort of the 1992 operation consisted of several attempts at stopping the lava front advance by divert…
Bronchial thermoplasty in severe asthma: food for thoughts
2014
Asthma is a complex inflammatory disorder of the airways characterized by airway hyper-responsiveness and variable, reversible, airflow obstruction. Bronchial thermoplasty (BT) is a new modality for treating asthma. It targets airway smooth muscles (ASM) by delivering a controlled specific amount of thermal energy (radiofrequency ablation) to the airway wall through a dedicated catheter. The use of bronchial thermoplasty has been widely discussed for its potential in the treatment of asthma, since it seems to be able to reduce the symptoms of asthma. The definitive study for BT (AIR2 trial) employed a randomized, double-blind, sham-controlled design and enrolled 288 subjects with severe per…
Laryngeal Mask Airway Position and the Risk of Gastric Insufflation
1998
A potential risk of the laryngeal mask airway (LMA) is an incomplete mask seal causing gastric insufflation or oropharyngeal air leakage.The objective of the present study was to assess the incidence of LMA malpositions by fiberoptic laryngoscopy, and to determine their influence on gastric insufflation and oropharyngeal air leakage. One hundred eight patients were studied after the induction of anesthesia, before any surgical manipulations. After clinically satisfactory LMA placement, tidal volumes were increased stepwise until air entered the stomach, airway pressure exceeded 40 cm H2 O, or air leakage from the mask seal prevented further increases in tidal volume. LMA position in relatio…
Internal Hernia Masquerading As Necrotizing Enterocolitis
2017
In extremely preterm infants, acute abdominal emergencies are fortunately less common with improving care. Spontaneous intestinal perforation and necrotizing enterocolitis are conditions where emergency surgery is most often needed. Conservative medical management and placement of temporary drain are often used in the initial management. Internal hernia (IH) is an uncommon cause of bowel obstruction in neonates, is difficult to diagnose and unfortunately are found only at autopsy. The presentation in preterm infants, distinction between these conditions, and the need for early diagnosis of IH are discussed.
Intestinal Involvement in Kawasaki Disease
2018
Objectives To describe a case of Kawasaki disease with intestinal involvement and to analyze other published reports to define clinical characteristics, diagnostic issues, and therapeutic approaches of gastrointestinal involvement in Kawasaki disease. Study design A computerized search without language restriction was conducted using PubMed and SCOPUS. An article was considered eligible for inclusion in the systematic review if it reported data on patient(s) with intestinal involvement in Kawasaki disease. Our case was also included in the analysis. Results Thirty-three articles reporting 48 cases of Kawasaki disease with intestinal involvement were considered. Fever, abdominal pain, and vo…
Could Chronic Idiopatic Intestinal Pseudo-Obstruction Be Related to Viral Infections?
2021
Chronic idiopathic intestinal pseudo-obstruction (CIIPO) is a disease characterized by symptoms and signs of small bowel obstruction in the absence of displayable mechanical obstruction. Due to the known neuropathic capacity of several viruses, and their localization in the intestine, it has been hypothesized that such viruses could be involved in the pathogenesis of CIIPO. The most frequently involved viruses are John Cunningham virus, Herpesviridae, Flaviviruses, Epstein–Barr virus and Citomegalovirus. Therefore, the present narrative review aims to sum up some new perspectives in the etiology and pathophysiology of CIIPO.
Intravenous Contrast Agent in Abdominal CT: Is It Really Needed to Identify the Cause of Bowel Obstruction? Proof of Concept
2019
Background. To compare sensitivity of unenhanced computed tomography (CT) and contrast-enhanced CT for the identification of the etiology of bowel obstruction.Materials and Methods. We retrospectively evaluated abdominal CT scans of patients operated for bowel obstruction from March 2013 to October 2017. Two radiologists evaluated CT scans before and after contrast agent in two reading sessions. Then, we calculated sensitivity of CT in the diagnosis of bowel obstruction and determined in which cases the etiology of bowel obstruction was detected on both unenhanced and enhanced CT or on enhanced CT only. The reference standard was defined as the final diagnosis obtained after surgery.Results…
Regional hypothermia of the kidney: surface or transarterial perfusion cooling? A functional study.
1980
Hypothermia reduces ischemic damage if prolonged occlusion of the renal artery is required during an in situ kidney operation. Hypothermia may be achieved by external cooling or by transarterial hypothermic perfusion. External cooling may lower intrarenal temperature heterogeneously. Perfusion techniques via intra-arterial catheters introduced percutaneously are associated with minimal technical difficulties. The 95 patients who underwent extensive hypothermic nephrolithotomy had differential 131iodine hippuran clearance studies preoperatively, and 2 weeks and 6 to 46 months postoperatively. Sixty-three kidneys were cooled by transarterial hypothermic perfusion and 39 were cooled with topic…