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Search on : colonic and pseudo-obstruction [Words]
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[PMID]: 29428026
[Au] Autor:Shahait AD; Mostafa G
[Ti] Title:Ogilvie's Syndrome or Colonic Pseudo-Obstruction.
[So] Source:Am Surg;84(1):e38-39, 2018 01 01.
[Is] ISSN:1555-9823
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[St] Status:In-Data-Review

  2 / 1164 MEDLINE  
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[PMID]: 29470625
[Au] Autor:Gu L; Yang B; Zhang X; Ding C; Tian H; Zhu W; Li J; Li N
[Ad] Address:Department of General Surgery, Jinling Hospital, Medicine School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, 210002, China.
[Ti] Title:Fluoroscopy-guided trans-anal decompression tube placement in the treatment of acute colonic pseudo-obstruction: a single center experience.
[So] Source:Abdom Radiol (NY);, 2018 Feb 22.
[Is] ISSN:2366-0058
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: Acute colonic pseudo-obstruction (ACPO or Ogilvie's syndrome) is a rare but often fatal disease; timely colonic decompression may be essential for successful treatment. This study describes a technique of placing a trans-anal tube via fluoroscopy-guiding and investigates the effect of colon decompression on ACPO. METHODS: Patients undergoing colonic decompression via fluoroscopy-guided trans-anal tube placement from April 2015 to May 2017 were included. The technical and clinical successes of this procedure were evaluated. Clinical features and long-term outcomes are described. RESULTS: Decompression was successful in 72.73% (16/22) of the patients; the procedure was considered a clinical success in 50% (11/22) of the patients. 31.82% (7/22) of the patients underwent elective surgery, and only 18.19% (4/22) of the patients need emergency surgery. CONCLUSIONS: Fluoroscopy-guided trans-anal decompression tube placement was an easy and efficient method for treating ACPO. Additionally, ACPO once required emergency surgery, but now may only require elective surgery in certain instances.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180222
[Lr] Last revision date:180222
[St] Status:Publisher
[do] DOI:10.1007/s00261-018-1509-0

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[PMID]: 29384906
[Au] Autor:Guo Y; He L; Liu Y; Cao X
[Ad] Address:Department of Gastrointestinal Surgery, First Hospital of Jilin University.
[Ti] Title:A rare case report of multiple myeloma presenting with paralytic ileus and type II respiratory failure due to hypercalcemic crisis.
[So] Source:Medicine (Baltimore);96(52):e9215, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Paralytic ileus is characterized by the signs and symptoms of intestinal obstruction but without any mechanical lesions in the intestinal lumen. Several medical and surgical conditions can lead to this ailment, such as electrolyte disturbances that impair intestinal motility. However, hypercalcemia secondary to multiple myeloma as a major cause of paralytic ileus has rarely been reported. PATIENT CONCERNS: The patient got severe constipation with difficulty in the passage of both gas and feces for 7 days. DIAGNOSES: The patient was diagnosed with a small intestinal obstruction initially and then developed type II respiratory failure. Investigations revealed hypercalcemic crisis, and examination of a bone marrow aspirate was consistent with multiple myeloma. INTERVENTIONS: Conservative treatment was administered for the intestinal obstruction, consisting of food and water deprivation, gastrointestinal decompression, colonic irrigation, intravenous fluid transfusion, anti-inflammatory therapy. Invasive respiratory support was provided after type II respiratory failure occurred and salmon calcitonin was used to reduce the blood calcium level. Further therapy was given by the Department of Hematology and Oncology in our hospital after the diagnosis of multiple myeloma. OUTCOMES: Spontaneous respiration and gastrointestinal function were restored after the correction of hypercalcemia. LESSONS: An appropriate diagnostic approach is needed in emergency practice to identify the paralytic ileus and type II respiratory failure caused by hypercalcemia secondary to multiple myeloma.
[Mh] MeSH terms primary: Hypercalcemia/complications
Intestinal Pseudo-Obstruction/etiology
Multiple Myeloma/complications
Multiple Myeloma/diagnosis
Respiratory Insufficiency/etiology
[Mh] MeSH terms secundary: Female
Humans
Hypercalcemia/diagnosis
Hypercalcemia/therapy
Middle Aged
Multiple Myeloma/therapy
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180209
[Lr] Last revision date:180209
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009215

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[PMID]: 29359574
[Au] Autor:Kram B; Greenland M; Grant M; Campbell ME; Wells C; Sommer C
[Ad] Address:1 Duke University Hospital, Durham, NC, USA.
[Ti] Title:Efficacy and Safety of Subcutaneous Neostigmine for Ileus, Acute Colonic Pseudo-obstruction, or Refractory Constipation.
[So] Source:Ann Pharmacother;:1060028018754302, 2018 Jan 01.
[Is] ISSN:1542-6270
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Neostigmine is traditionally administered intravenously for treatment of acute colonic pseudo-obstruction (ACPO), though use is associated with administration constraints and adverse effects. OBJECTIVE: To evaluate whether an alternative route of administration for neostigmine via subcutaneous (SQ) delivery is safe and effective in a broad cohort of medical and surgical patients. METHODS: This multicenter, retrospective observational study included adult patients administered SQ neostigmine for ileus, ACPO, or refractory constipation. Efficacy indicators were time to first bowel movement (BM) following initiation of the medication, total SQ neostigmine dose administered to produce a BM, and administration of a rescue intervention to produce a BM. Safety events evaluated were cardiac arrest, bradycardia, bronchospasm requiring intervention, nausea requiring intervention, or severe salivation, lacrimation, or diarrhea. RESULTS: A total of 182 patients were eligible for inclusion. The most commonly utilized dosing strategy of neostigmine was 0.25 mg SQ 4 times daily. The median time to first BM following initiation of SQ neostigmine was 29.19 hours (interquartile range = 12.18-56.84) with a median dose administered before first BM of 1.25 mg. Three patients (1.65%) experienced an adverse drug event leading to drug discontinuation, with 2 developing bradycardia that resolved with drug discontinuation alone. CONCLUSIONS: SQ neostigmine may be reasonable for management of ileus, ACPO, or refractory constipation, though use should be avoided in patients with new-onset heart block, a history of second-degree heart block, or following bowel resection with primary anastomosis. Despite the low incidence of adverse drug events observed, monitoring for bradycardia with telemetry may be considered.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180123
[Lr] Last revision date:180123
[St] Status:Publisher
[do] DOI:10.1177/1060028018754302

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[PMID]: 29265641
[Au] Autor:de Jonge CS; Smout AJPM; Nederveen AJ; Stoker J
[Ad] Address:Department of Radiology and Nuclear Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, the Netherlands.
[Ti] Title:Evaluation of gastrointestinal motility with MRI: Advances, challenges and opportunities.
[So] Source:Neurogastroenterol Motil;30(1), 2018 Jan.
[Is] ISSN:1365-2982
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Dynamic magnetic resonance imaging (MRI) of gastrointestinal motility has developed rapidly over the past few years. The non-invasive and non-ionizing character of MRI is an important advantage together with the fact that it is fast and can visualize the entire gastrointestinal tract. Advances in imaging and quantification techniques have facilitated assessment of gastric, small intestinal, and colonic motility in a clinical setting. Automated quantitative motility assessment using dynamic MRI meets the need for non-invasive techniques. Recently, studies have begun to examine this technique in patients, including those with IBD, pseudo-obstruction and functional bowel disorders. Remaining challenges for clinical implementation are processing the large amount of data, standardization and validation of the numerous MRI metrics and subsequently assessment of the potential role of dynamic MRI. This review examines the methods, advances, and remaining challenges of evaluation of gastrointestinal motility with MRI. It accompanies an article by Khalaf et al. in this journal that describes a new protocol for assessment of pan-intestinal motility in fasted and fed state in a single MRI session.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1712
[Cu] Class update date: 171221
[Lr] Last revision date:171221
[St] Status:In-Process
[do] DOI:10.1111/nmo.13257

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[PMID]: 29128300
[Au] Autor:Reignier J; Boisramé-Helms J; Brisard L; Lascarrou JB; Ait Hssain A; Anguel N; Argaud L; Asehnoune K; Asfar P; Bellec F; Botoc V; Bretagnol A; Bui HN; Canet E; Da Silva D; Darmon M; Das V; Devaquet J; Djibre M; Ganster F; Garrouste-Orgeas M; Gaudry S; Gontier O; Guérin C; Guidet B; Guitton C; Herbrecht JE; Lacherade JC; Letocart P; Martino F; Maxime V; Mercier E; Mira JP; Nseir S; Piton G; Quenot JP; Richecoeur J; Rigaud JP; Robert R; Rolin N; Schwebel C; Sirodot M; Tinturier F; Thévenin D; Giraudeau B; Le Gouge A; NUTRIREA-2 Trial Investigators; Clinical Research in Intensive Care and Sepsis (CRICS) group
[Ad] Address:Médecine Intensive Réanimation, CHU de Nantes, Nantes, France; Université de Nantes, Nantes, France. Electronic address: jean.reignier@chu-nantes.fr.
[Ti] Title:Enteral versus parenteral early nutrition in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2).
[So] Source:Lancet;, 2017 Nov 08.
[Is] ISSN:1474-547X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Whether the route of early feeding affects outcomes of patients with severe critical illnesses is controversial. We hypothesised that outcomes were better with early first-line enteral nutrition than with early first-line parenteral nutrition. METHODS: In this randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2 trial) done at 44 French intensive-care units (ICUs), adults (18 years or older) receiving invasive mechanical ventilation and vasopressor support for shock were randomly assigned (1:1) to either parenteral nutrition or enteral nutrition, both targeting normocaloric goals (20-25 kcal/kg per day), within 24 h after intubation. Randomisation was stratified by centre using permutation blocks of variable sizes. Given that route of nutrition cannot be masked, blinding of the physicians and nurses was not feasible. Patients receiving parenteral nutrition could be switched to enteral nutrition after at least 72 h in the event of shock resolution (no vasopressor support for 24 consecutive hours and arterial lactate <2 mmol/L). The primary endpoint was mortality on day 28 after randomisation in the intention-to-treat-population. This study is registered with ClinicalTrials.gov, number NCT01802099. FINDINGS: After the second interim analysis, the independent Data Safety and Monitoring Board deemed that completing patient enrolment was unlikely to significantly change the results of the trial and recommended stopping patient recruitment. Between March 22, 2013, and June 30, 2015, 2410 patients were enrolled and randomly assigned; 1202 to the enteral group and 1208 to the parenteral group. By day 28, 443 (37%) of 1202 patients in the enteral group and 422 (35%) of 1208 patients in the parenteral group had died (absolute difference estimate 2·0%; [95% CI -1·9 to 5·8]; p=0·33). Cumulative incidence of patients with ICU-acquired infections did not differ between the enteral group (173 [14%]) and the parenteral group (194 [16%]; hazard ratio [HR] 0·89 [95% CI 0·72-1·09]; p=0·25). Compared with the parenteral group, the enteral group had higher cumulative incidences of patients with vomiting (406 [34%] vs 246 [20%]; HR 1·89 [1·62-2·20]; p<0·0001), diarrhoea (432 [36%] vs 393 [33%]; 1·20 [1·05-1·37]; p=0·009), bowel ischaemia (19 [2%] vs five [<1%]; 3·84 [1·43-10·3]; p=0·007), and acute colonic pseudo-obstruction (11 [1%] vs three [<1%]; 3·7 [1·03-13·2; p=0·04). INTERPRETATION: In critically ill adults with shock, early isocaloric enteral nutrition did not reduce mortality or the risk of secondary infections but was associated with a greater risk of digestive complications compared with early isocaloric parenteral nutrition. FUNDING: La Roche-sur-Yon Departmental Hospital and French Ministry of Health.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171112
[Lr] Last revision date:171112
[St] Status:Publisher

  7 / 1164 MEDLINE  
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[PMID]: 29018144
[Au] Autor:Robinson AJ; Quigley JP; Banks A; Farmer M
[Ad] Address:Department of Urology, Royal Stoke University Hospital, Stoke-on-Trent, UK.
[Ti] Title:Ogilvie's syndrome treated with an emergency laparotomy, right hemicolectomy and end ileostomy.
[So] Source:BMJ Case Rep;2017, 2017 Oct 09.
[Is] ISSN:1757-790X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Acute colonic pseudo-obstruction (ACPO), or Ogilvie's syndrome, is a rare clinical entity in which there is massive non-toxic colonic dilatation in the absence of a mechanically obstructing lesion. It is an important yet poorly recognised cause of surgical morbidity and mortality occurring typically in elderly patients with multiple comorbidities. ACPO can often be reversed conservatively with colonoscopic or nasogastric decompression. Surgical intervention is seldom necessary. We present a case of Ogilvie's syndrome in which a healthy 76-year-old man developed life-threatening pseudo-obstruction following rib polytrauma after a mechanical fall. Pneumatosis coli was evident radiologically, prompting emergency exploratory laparotomy. Operative findings of serosal tearing and ischaemic colitis necessitated treatment with right hemicolectomy and ileostomy formation. Microbiological and histopathological analyses proved negative for inflammatory, obstructive and infectious colitides. The case emphasises the importance of early recognition and timely intervention in the management of this rare yet potentially fatal cause of megacolon.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171011
[Lr] Last revision date:171011
[St] Status:In-Process

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[PMID]: 28992679
[Au] Autor:Chung JY; Park JS; Kim YS
[Ad] Address:Department of Anesthesiology, Wonkwang University Sanbon Hospital, Gunpo, Gyeonggi-do, Korea.
[Ti] Title:A Rare Cause of Acute Colonic Pseudo-obstruction: Ogilvie's Syndrome Caused by Herpes Zoster.
[So] Source:J Neurogastroenterol Motil;23(4):616-617, 2017 Oct 30.
[Is] ISSN:2093-0879
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Pt] Publication type:LETTER
[Em] Entry month:1710
[Cu] Class update date: 171018
[Lr] Last revision date:171018
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.5056/jnm17078

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[PMID]: 28927774
[Au] Autor:Giabicani E; Lemale J; Dainese L; Boudjemaa S; Coulomb A; Tounian P; Dubern B
[Ad] Address:Nutrition et gastroentérologie pédiatriques, hôpital Trousseau, AP-HP, 26, avenue du Dr-Netter, 75012 Paris, France.
[Ti] Title:Chronic intestinal pseudo-obstruction in a child with Treacher Collins syndrome.
[So] Source:Arch Pediatr;24(10):1000-1004, 2017 Oct.
[Is] ISSN:1769-664X
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:BACKGROUND: Treacher Collins syndrome (TCS) mainly presents with severe craniofacial developmental abnormalities characterized by a combination of bilateral downward-slanting palpebral fissures, colobomas of the lower eyelids, hypoplasia of the facial bones, cleft palate, malformation of the external ears, atresia of the external auditory canals, and bilateral conductive hearing loss. It is due to mutations in Treacher Collins syndrome 1 (TCOF1) (5q32-q33.1) and Polymerase RNA 1 polypeptides D and C (POLR1D [13q12.2], and POLR1C [6p21.1]) genes, which are responsible for increased neuroepithelial apoptosis during embryogenesis resulting in the lack of neural crest cells involved in facial bone and cartilage formation. Altered function of the upper digestive tract has been reported, whereas severe dysmotility disorders have never been reported. We describe here the first case of TCS associated with histologically proven chronic intestinal pseudo-obstruction (CIPO) in humans. Case presentatios A 12-year-old boy with TCS due to TCOF1 gene deletion experienced nutritional difficulties and digestive intolerance from birth. CIPO was suspected during childhood because of severe intestinal dysmotility leading to enteral-jejunal nutrition intolerance and dependence on total parenteral nutrition. Diagnosis of CIPO with nervous abnormalities was histologically confirmed on a surgical rectal biopsy that showed enlarged ganglionic myenteric plexus. At the age of 9 years, an isolated colonic stenosis without dilatation responsible for severe abdominal pain and altered quality of life led to digestive derivation contributing to rapid disappearance of chronic abdominal pain. At the age of 12 years, the patient was still dependent on total home parenteral nutrition 7 days a week to maintain regular growth velocity. CONCLUSION: Recently, mice studies have pointed out the role played by TCOF1 in ganglionic cell migration in the foregut, suggesting that the synergistic haploinsufficiency of Tcof1 and Pax3, a transcription factor regulating the RET gene involved in disorders of neural crest cell development, probably results in colonic aganglionosis and may explain the association described here between TCS and CIPO. This case may correspond to this possible mechanism in humans. These findings and our clinical report suggest that CIPO may be assessed as unusual digestive manifestations in TCS with TCOF1 deletion.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 171007
[Lr] Last revision date:171007
[St] Status:In-Process

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[PMID]: 28852322
[Au] Autor:Wells CI; O'Grady G; Bissett IP
[Ad] Address:Cameron I Wells, Gregory O'Grady, Ian P Bissett, Department of Surgery, University of Auckland, Auckland 1010, New Zealand.
[Ti] Title:Acute colonic pseudo-obstruction: A systematic review of aetiology and mechanisms.
[So] Source:World J Gastroenterol;23(30):5634-5644, 2017 Aug 14.
[Is] ISSN:2219-2840
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:AIM: To critically review the literature addressing the definition, epidemiology, aetiology and pathophysiology of acute colonic pseudo-obstruction (ACPO). METHODS: A systematic search was performed to identify articles investigating the aetiology and pathophysiology of ACPO. A narrative synthesis of the evidence was undertaken. RESULTS: No consistent approach to the definition or reporting of ACPO has been developed, which has led to overlapping investigation with other conditions. A vast array of risk factors has been identified, supporting a multifactorial aetiology. The pathophysiological mechanisms remain unclear, but are likely related to altered autonomic regulation of colonic motility, in the setting of other predisposing factors. CONCLUSION: Future research should aim to establish a clear and consistent definition of ACPO, and elucidate the pathophysiological mechanisms leading to altered colonic function. An improved understanding of the aetiology of ACPO may facilitate the development of targeted strategies for its prevention and treatment.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1708
[Cu] Class update date: 170902
[Lr] Last revision date:170902
[St] Status:In-Process
[do] DOI:10.3748/wjg.v23.i30.5634


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