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[PMID]:28834982
[Au] Autor:Goetz A; da Silva NPB; Moser C; Agha A; Dendl LM; Stroszczynski C; Schreyer AG
[Ad] Endereço:University Hospital Regensburg, Department of Radiology, Regensburg, Germany.
[Ti] Título:Clinical Value of Contrast Enema Prior to Ileostomy Closure.
[Ti] Título:Klinische Wertigkeit der Durchleuchtungsuntersuchung des aboralen Stomaschenkels mittels Kontrasteinlauf..
[So] Source:Rofo;189(9):855-863, 2017 Sep.
[Is] ISSN:1438-9010
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:To determine the value of routine contrast enema of loop ileostomy before elective ileostomy closure regarding the influence on the clinical decision-making. Retrospective analysis of contrast enemas at a tertiary care center between 2005 und 2011. Patients were divided into two groups: Group I with ileostomy reversal, group II without ileostomy closure. Patient-related parameters (underlying disease, operation method) and parameters based on the findings (stenosis, leakage of anastomosis, incontinence) were evaluated. Analyzing a total of 252 patients in 89 % (group I, n = 225) ileostomy closure was performed. In 15 % the radiologic report was the only diagnostic modality needed for therapy decision; in 36 % the contrast enema and one or more other diagnostic methods were decisive. In 36 % the radiological report of the contrast imaging was not relevant for decision at all. In 11 % (group II, n = 27) no ileostomy closure was performed. In this group in 11 % the radiological report of the contrast enema was the only decision factor for not performing the ileostomy reversal. In 26 % one or more examination was necessary. In 26 % the result of the contrast examination was not relevant. The radiologic contrast imaging of loop ileostomy solely plays a minor role in complex surgical decision-making before planned reversal, but is important as first imaging method in detecting complications and often leads to additional examinations. · Contrast enema of loop ileostomy before planned ileostomy closure is a frequently performed examination.. · There exist no general guidelines that give further recommendations on decision-making planning ileostomy closure.. · The radiologic contrast imaging of loop ileostomy solely plays a minor role in decision-making before planned reversal, but is important as first imaging method.. · Goetz A, da Silva NP, Moser C et al. Clinical Value of Contrast Enema Prior to Ileostomy Closure. Fortschr Röntgenstr 2017; 189: 855 - 863.
[Mh] Termos MeSH primário: Enama Opaco/utilização
Ileostomia/utilização
Cuidados Pré-Operatórios/estatística & dados numéricos
Cirurgia Assistida por Computador/estatística & dados numéricos
Técnicas de Fechamento de Ferimentos/utilização
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Compostos de Bário
Tomada de Decisão Clínica
Meios de Contraste
Procedimentos Cirúrgicos Eletivos/utilização
Feminino
Alemanha/epidemiologia
Seres Humanos
Masculino
Meia-Idade
Prevalência
Estudos Retrospectivos
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Barium Compounds); 0 (Contrast Media)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170824
[St] Status:MEDLINE
[do] DOI:10.1055/s-0043-111598


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[PMID]:28154903
[Au] Autor:Chen X; Xiaojuan W; Zhang H; Jiao C; Yu K; Zhu T; Feng J
[Ad] Endereço:Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, China.
[Ti] Título:Diagnostic value of the preoperatively detected radiological transition zone in Hirschsprung's disease.
[So] Source:Pediatr Surg Int;33(5):581-586, 2017 May.
[Is] ISSN:1437-9813
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVE: The cardinal diagnostic sign of congenital aganglionic megacolon, or Hirschsprung's disease (HD), is an aganglionic segment of the distal colon or rectum. To determine the surgical planning of a radiological transition zone (TZ) in HD, this study investigated the association between a radiological TZ and the bowel resection length. METHODS: A prospective observational study was conducted in children (n = 192) with suspected HD determined by radiological TZ on contrast barium enema, and who underwent pull-through operations. The bowel resection length was ≥10 cm above the proximal radiological TZ levels and confirmed by intraoperative frozen sections. In the contrast enema, the presence and level of a radiological TZ were recorded. Correlation of the TZ features with ganglion cells assessed by immunostaining of neuronal nuclei (NeuN) and the odds ratio were calculated. RESULTS: The sensitivity and specificity for diagnosing HD by the presence of a radiological TZ were 86.9 and 92.1%, respectively; Youden's index was 79.0%. The positive and negative predictive values were 91.7 and 87.6%. The kappa value indicating an association between TZ and HD was 0.776 (P < 0.05). The correlation rate between a radiological TZ and the pathological results was 88.5% in the rectosigmoid colon and 44.4% in the descending colon, and was higher in children older than 3 months (85.3%) than in infants (69.0%). CONCLUSION: A preoperatively determined radiological TZ has potential value to identify the length of resected bowel in patients with HD, and it also has a high predictive value for diagnosis of HD.
[Mh] Termos MeSH primário: Enama Opaco/métodos
Doença de Hirschsprung/diagnóstico por imagem
Doença de Hirschsprung/cirurgia
Cuidados Pré-Operatórios/métodos
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Colo/diagnóstico por imagem
Colo/cirurgia
Feminino
Seres Humanos
Lactente
Masculino
Estudos Prospectivos
Reto/diagnóstico por imagem
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170204
[St] Status:MEDLINE
[do] DOI:10.1007/s00383-017-4064-9


  3 / 6 MEDLINE  
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Texto completo SciELO Brasil
[PMID]:27759777
[Au] Autor:Peyvasteh M; Askarpour S; Ostadian N; Moghimi MR; Javaherizadeh H
[Ad] Endereço:Department of Pediatric Surgery, Imam Khomeini Hospital, Iran.
[Ti] Título:DIAGNOSTIC ACCURACY OF BARIUM ENEMA FINDINGS IN HIRSCHSPRUNG'S DISEASE.
[So] Source:Arq Bras Cir Dig;29(3):155-158, 2016 Jul-Sep.
[Is] ISSN:2317-6326
[Cp] País de publicação:Brazil
[La] Idioma:eng; por
[Ab] Resumo:Background: : Hirschsprung's disease is the most common cause of pediatric intestinal obstruction. Contrast enema is used for evaluation of the patients with its diagnosis. Aim: : To evaluate sensitivity, specificity, positive predictive value, and negative predictive value of radiologic findings for diagnosis of Hirschsprung in patients underwent barium enema. Methods:: This cross sectional study was carried out in Imam Khomeini Hospital for one year starting from 2012, April. Sixty patients were enrolled. Inclusion criteria were: neonates with failure to pass meconium, abdominal distention, and refractory constipation who failed to respond with medical treatment. Transitional zone, delay in barium evacuation after 24 h, rectosigmoid index (maximum with of the rectum divided by maximum with of the sigmoid; abnormal if <1), and irregularity of mucosa (jejunization) were evaluated in barium enema. Biopsy was obtained at three locations apart above dentate line. PPV, NPV, specificity , and sensitivity was calculated for each finding. Results:: Mean age of the cases with Hirschsprung's disease and without was 17.90±18.29 months and 17.8±18.34 months respectively (p=0.983). It was confirmed in 30 (M=20, F=10) of cases. Failure to pass meconium was found in 21(70%) cases. Sensitivity, specificity, PPV, and NPV were 90%, 80%, 81.8% and 88.8% respectively for transitional zone in barium enema. Sensitivity, specificity, PPV, and NPV were 76.7%, 83.3%, 78.1% and 82.1% respectively for rectosigmoid index .Sensitivity, specificity, PPV, and NPV were 46.7%, 100%, 100% and 65.2% respectively for irregular contraction detected in barium enema. Sensitivity, specificity, PPV, and NPV were 23.3%, 100%, 100% and 56.6% respectively for mucosal irregularity in barium enema. Conclusion: : The most sensitive finding was transitional zone. The most specific findings were irregular contraction, mucosal irregularity, and followed by cobblestone appearance. Racional:: A doença de Hirschsprung é a causa mais comum de obstrução intestinal pediátrica. Enema baritado é usado para a avaliação dos pacientes com o diagnóstico . Objetivo:: Avaliar a sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo de achados radiológicos para diagnóstico de Hirschsprung em pacientes submetidos ao enema opaco. Métodos:: Este estudo transversal foi realizado em Imam Khomeini Hospital por um ano a partir de abril de 2012. Sessenta pacientes foram incluídos. Os critérios de inclusão foram: recém-nascidos com insuficiência de passagem de mecônio, distensão abdominal, e constipação refratária sem resposta ao tratamento médico. Foram avaliadas no enema zona de transição, atraso na evacuação de bário após 24 h, índice retossigmoide (máximo do diâmetro do reto dividido pelo máximo do sigmóide; anormal se <1), e as irregularidades da mucosa (jejunização). Biópsia foi obtida em três localizações acima da linha dentada. VPP, VPN, especificidade e sensibilidade foram calculados para cada achado. Resultados:: A idade média dos casos com a doença de Hirschsprung e sem foi 17,90±18,29 meses e 17,8±18,34 meses, respectivamente (p=0,983). Confirmou-se em 30 (M=20, F=10) dos casos. Falha no mecônio foi encontrada em 21 (70%) casos. Sensibilidade, especificidade, VPP e VPN foram de 90%, 80%, 81,8% e 88,8%, respectivamente, para a zona de transição no enema. Sensibilidade, especificidade, VPP e VPN foram 76,7%, 83,3%, 78,1% e 82,1%, respectivamente para o índice de retossigmoide. Sensitividade, especificidade, VPP e VPN foram 46,7%, 100%, 100% e 65,2%, respectivamente, para contração irregular detectada no enema baritado. Sensibilidade, especificidade, VPP e VPN foram de 23,3%, 100%, 100% e 56,6%, respectivamente, para a irregularidade da mucosa. Conclusão:: O achado mais sensível foi zona de transição. Os achados mais específicos foram contração irregular, irregularidade da mucosa, e seguido por aparecimento de mucosa em forma de paralelepípedos.
[Mh] Termos MeSH primário: Enama Opaco
Doença de Hirschsprung/diagnóstico por imagem
[Mh] Termos MeSH secundário: Pré-Escolar
Estudos Transversais
Feminino
Seres Humanos
Lactente
Masculino
Valor Preditivo dos Testes
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170309
[Lr] Data última revisão:
170309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161021
[St] Status:MEDLINE


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[PMID]:27680077
[Au] Autor:Yu Z; Liu Q; Xiao Z; Li D; Huang X; Huang Z
[Ti] Título:[Preliminary exploration on accurately preoperative evaluation of colonic lesions in slow transit constipation complicated with adult megacolon].
[So] Source:Zhonghua Wei Chang Wai Ke Za Zhi;19(9):1049-1053, 2016 Sep 25.
[Is] ISSN:1671-0274
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVE: To investigate the application value of colonic transit test (CTT) combined with anorectal manometry (ARM), barium enema (BE) and defecography (DFG) in accurately evaluating colonic lesions of slow transit constipation complicated with adult megacolon. METHODS: Clinical data of 47 above patients admitted between October 2007 and February 2015 in the People's Hospital of Hunan Province were analyzed retrospectively. All the patients were examined with≥2 times of CTT combined with ARM and BE, and 42 cases received additional DFG at the same time, to evaluate colonic lesions before operation. Operative biopsy pathology was used as the standard. The sensitivity, specificity, positive predictive value(PPV) and negative predictive value(NPV) of positioning in the ascending colon and caecum, transverse colon and descending colon were calculated, and the consistency was represented by Kappa test(Kappa value≥0.75 indicates good consistency, meanwhile higher Kappa value indicates better consistency). The Heikkinen score was used to evaluate defecation function at postoperative 6 months. RESULTS: The age of 47 patients was from 18 to 56 years old. Compared with intraoperative findings and biopsy pathology, the diagnostic coincidence rate was 89.4% by CTT combined with BE and DFG positioning, which suggested pathology-changed colonic segment locating in the ascending colon and cecum (n=12), transverse colon (n=26) and descending colon (n=9), while intraoperative findings and biopsy pathology suggested pathology-changed colonic segment locating in the ascending colon and cecum (n=11), transverse colon (n=23) and descending colon (n=13). The sensitivity was 88.3%, specificity 93.5%, PPV 92.1%, NPV 94.9% and Kappa value was 0.827(P<0.001). Procedures performed included segmental colectomy (n=8), subtotal colectomy (n=29), total colectomy (n=10). There was no serious complication during and after operation. Defecatory function was excellent in 24 cases (60.0%), good in 10 (25.0%), and moderate in 6 (15.0%) evaluated by Heikkinen score at postoperative 6 months. A total of 40 patients were followed up from 1 to 7 years (median 3 years) and there was no long-term diarrhea and recurrence of constipation or giant colon after operation. CONCLUSION: Preoperative detection of CTT combined with ARM, BE and DFG in patients with slow transit constipation complicated with adult megacolon can make a more precise assessment of the extent of colonic lesions in advance, which has a good clinical predictive value.
[Mh] Termos MeSH primário: Ceco/patologia
Colo/patologia
Colo/cirurgia
Constipação Intestinal/diagnóstico
Constipação Intestinal/patologia
Constipação Intestinal/cirurgia
Megacolo/patologia
Megacolo/cirurgia
Valor Preditivo dos Testes
[Mh] Termos MeSH secundário: Adolescente
Adulto
Enama Opaco
Ceco/fisiopatologia
Ceco/cirurgia
Colectomia/métodos
Colo/fisiopatologia
Constipação Intestinal/complicações
Defecografia
Feminino
Trânsito Gastrointestinal/fisiologia
Seres Humanos
Masculino
Manometria
Megacolo/complicações
Meia-Idade
Período Pré-Operatório
Prognóstico
Recuperação de Função Fisiológica/fisiologia
Estudos Retrospectivos
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160930
[St] Status:MEDLINE


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[PMID]:26831533
[Au] Autor:Grant CN; Golden JM; Anselmo DM
[Ad] Endereço:Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.
[Ti] Título:Routine contrast enema is not required for all infants prior to ostomy reversal: A 10-year single-center experience.
[So] Source:J Pediatr Surg;51(7):1138-41, 2016 Jul.
[Is] ISSN:1531-5037
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The incidence of intestinal stricture is low for most conditions requiring a primary small bowel stoma in infants. Routine performance of contrast enemas (CE) prior to stoma closure adds cost and radiation exposure. We hypothesized that routine CE prior to ostomy reversal is not necessary in all infants, and sought to identify a subset of patients who may benefit from preoperative CE. METHODS: Medical records of infants under age 1 (N=161) undergoing small bowel stoma reversal at a single institution between 2003 and 2013 were retrospectively reviewed. Student's T-test was used to compare groups. RESULTS: Contrast enemas were performed on 80% of all infants undergoing small bowel ostomy reversal during the study period. Infants with necrotizing enterocolitis (NEC) were more likely to have a CE than those with intestinal atresia (p=0.03) or those with all other diagnoses combined (p=0.03). Nine strictures were identified on CE. Of those, 8 (89%) were in patients with NEC, and only 4 were clinically significant and required operative resection. The overall relevant stricture rate was 2.5%. No patient that underwent ostomy takedown without CE had a stricture diagnosed intraoperatively or an unrecognized stricture that presented clinically after stoma takedown. CONCLUSIONS: Routine CE is not required prior to small bowel ostomy reversal in infants. We recommend judicious use of enema studies in patients with NEC and high likelihood of stricture.
[Mh] Termos MeSH primário: Enama Opaco/utilização
Enterostomia
Obstrução Intestinal/diagnóstico por imagem
Intestino Delgado/cirurgia
Padrões de Prática Médica/estatística & dados numéricos
Cuidados Pré-Operatórios/métodos
Procedimentos Desnecessários/utilização
[Mh] Termos MeSH secundário: California
Feminino
Seguimentos
Seres Humanos
Lactente
Recém-Nascido
Obstrução Intestinal/etiologia
Obstrução Intestinal/cirurgia
Intestino Delgado/diagnóstico por imagem
Masculino
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160203
[St] Status:MEDLINE


  6 / 6 MEDLINE  
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[PMID]:26655788
[Au] Autor:Lasarte A; Novas P; Ugarte M
[Ad] Endereço:Department of Radiology, Mendaro Hospital, Mendarozabal Kalea, s/n, 20850, Mendaro, Spain. Electronic address: aitor.lasarteizcue@osakidetza.eus.
[Ti] Título:Returning traveler with persistent diarrhea.
[So] Source:Eur J Intern Med;29:e5-6, 2016 Apr.
[Is] ISSN:1879-0828
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Mh] Termos MeSH primário: Ascaríase/diagnóstico por imagem
Ascaríase/tratamento farmacológico
Diarreia/etiologia
Viagem
[Mh] Termos MeSH secundário: Dor Abdominal
Adulto
Albendazol/administração & dosagem
Animais
Anti-Helmínticos/administração & dosagem
Ascaris lumbricoides
Enama Opaco
Diarreia/parasitologia
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anthelmintics); F4216019LN (Albendazole)
[Em] Mês de entrada:1612
[Cu] Atualização por classe:170113
[Lr] Data última revisão:
170113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151215
[St] Status:MEDLINE



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