==================================CMR27================================== 27. Cecostomy - complications/management. Colocutaneous fistulae. Pseudo-obstruction of colon ('Ogilvies Syndrome'). 1 UI - 87110495 AU - Runyon BA TI - Fatal bacterial peritonitis secondary to nonobstructive colonic dilatation (Ogilvie's syndrome) in cirrhotic ascites. AB - A cirrhotic woman developed pneumococcal pneumonia with sepsis. Antibiotic therapy initially resulted in defervescence. However, nonobstructive colonic dilatation developed along with fever and clinical deterioration. Abdominal paracentesis and blood cultures revealed Escherichia coli bacterial peritonitis and bacteremia. The patient died. Autopsy revealed massive cecal mucosal ulceration, which was interpreted as the cause of the bacterial peritonitis. MH - Adult ; Ascitic Fluid/MICROBIOLOGY ; Autopsy ; Case Report ; Cecal Diseases/MICROBIOLOGY ; Cecum/BLOOD SUPPLY/MICROBIOLOGY ; Colonic Pseudo-Obstruction/*COMPLICATIONS/MICROBIOLOGY ; Escherichia Coli Infections/MICROBIOLOGY ; Female ; Human ; Intestinal Pseudo-Obstruction/*COMPLICATIONS ; Ischemia/ MICROBIOLOGY ; Liver Cirrhosis, Alcoholic/*COMPLICATIONS ; Mucous Membrane/MICROBIOLOGY ; Necrosis ; Peritonitis/*MICROBIOLOGY ; Ulcer/MICROBIOLOGY SO - J Clin Gastroenterol 1986 Dec;8(6):687-9 2 UI - 87110481 AU - Rolston DD ; Fairclough PD ; Wilks M ; Levison DA ; Farthing MJ TI - Spiral organisms in the human jejunum. AB - Spiral organisms were found in close apposition to the jejunal mucosa in a patient with idiopathic intestinal pseudoobstruction. Such organisms are generally not found in the jejunum and their presence in this patient was considered to be related to intestinal stasis, and possibly to diarrhea. MH - Adult ; Case Report ; Chronic Disease ; Female ; Human ; Intestinal Mucosa/MICROBIOLOGY ; Intestinal Pseudo-Obstruction/ *MICROBIOLOGY ; Jejunal Diseases/*MICROBIOLOGY ; Jejunum/ *MICROBIOLOGY ; Microscopy, Electron, Scanning ; Spirochaetales/ *ISOLATION & PURIFICATION/ULTRASTRUCTURE ; Support, Non-U.S. Gov't SO - J Clin Gastroenterol 1986 Dec;8(6):628-9 3 UI - 87078308 AU - Mastro AM ; Hurley DJ ; Winning RK ; Filipowski R ; Ogilvie ML ; Gartner TK TI - Mitogenic activity of snake venom lectins. AB - Five lactose-inhibitable lectins have been isolated from snake venoms. These five share certain biochemical properties but are not identical (Gartner, Stocker & Williams, 1980; Gartner & Ogilvie, 1984). In this study the lectins were tested for their ability to stimulate lymphocytes to undergo DNA synthesis. We found that three of the lectins were comparable in mitogenic activity to the T cell lectin, concanavalin A (Con A). The mitogenic activity was blocked by lactose, a sugar which also blocks the haemagglutination activity of these lectins. Although mitogenic response appeared to be due to T cells, it depended on the presence of accessory cells in the culture. This requirement for macrophages could be replaced by the phorbol ester tumour promoter, 12-o-tetradecanoylphorbol-13-acetate (TPA). MH - Animal ; Cattle ; Drug Synergism ; In Vitro ; Lactose/ PHARMACODYNAMICS ; Lectins/ANTAGONISTS & INHIBITORS/ *PHARMACODYNAMICS ; Lymphocyte Transformation/DRUG EFFECTS ; Lymphocytes/CYTOLOGY ; Macrophages/PHYSIOLOGY ; *Mitogens/ ANTAGONISTS & INHIBITORS ; Snake Venoms/*ANALYSIS ; Support, U.S. Gov't, P.H.S. ; Tetradecanoylphorbol Acetate/PHARMACODYNAMICS SO - Cell Tissue Kinet 1986 Sep;19(5):557-66 4 UI - 87072305 AU - Paes EH ; Rahmer H ; Almon W TI - Temporary Witzel enterostomy in decompensated small-bowel obstruction or paralytic ileus. AB - The technique of temporary Witzel enterostomy and its indications are reported and results in 81 patients (99 enterostomies) retrospectively reviewed. The procedure is recommended as an adjunct to primary surgery in cases of small-bowel obstruction with severe distention, extensive peritoneal defects and compromised vascularity, in paralytic ileus due to generalized peritonitis and in peritoneal carinomatosis. With the Witzel tunnel, postoperative bowel paralysis can be prevented, endangered anastomosis protected, bowel function directly monitored and long-term intestinal decompression achieved in patients with obstruction due to peritoneal carcinomatosis. The tube is easily removed when bowel function has normalized. The overall mortality in the series was 25% and the rate of enterostomyrelated complications 10%. There were no enterocutaneous fistulas requiring surgical correction. Possible long-term complications due to narrowing at the enterostomy site could not be assessed. Carefully constructed Witzel enterostomy, used on suitable indications, is an effective procedure in the management of small-bowel obstruction and peritonitis. MH - Adolescence ; Adult ; Aged ; Catheters, Indwelling ; Child ; Female ; Human ; Intestinal Obstruction/*SURGERY ; Intestinal Pseudo-Obstruction/*SURGERY ; Male ; Methods ; Middle Age ; Peritoneal Neoplasms/SURGERY ; Postoperative Complications/ MORTALITY ; Retrospective Studies SO - Acta Chir Scand 1986 Aug-Sep;152:521-5 5 UI - 87060672 AU - Moore JG ; Gladstone NS ; Lucas GW ; Ravry MJ ; Ansari AH TI - Successful management of post-cesarean-section acute pseudoobstruction of the colon (Ogilvie's syndrome) with colonoscopic decompression. A case report. AB - Although acute pseudoobstruction of the colon is a rare entity, a large percentage of the reported cases have occurred following obstetric and gynecologic surgical procedures. Early recognition is mandatory to avoid severe and potentially fatal complications and can allow successful decompression by means of colonoscopy, thus avoiding surgical intervention, as in the case reported on here. MH - Acute Disease ; Adult ; Case Report ; *Cesarean Section ; Colonic Pseudo-Obstruction/ETIOLOGY/*THERAPY ; *Colonoscopy ; Female ; Human ; Intestinal Pseudo-Obstruction/*THERAPY ; Postoperative Complications/ETIOLOGY/*THERAPY ; Pregnancy SO - J Reprod Med 1986 Oct;31(10):1001-4 6 UI - 87052292 AU - Anuras S ; Baker CR Jr TI - The colon in the pseudoobstructive syndrome. AB - Colonic pseudoobstruction can occur as part of a generalized chronic intestinal pseudoobstruction syndrome or as an isolated entity. Isolated colonic pseudoobstruction can occur in two unrelated forms: the acute and chronic forms. Acute colonic pseudoobstruction is frequently a hospital-acquired disease that arises as a complication of other illnesses. The syndrome must be recognized and treated with early colonoscopic decompression to prevent cecal or colonic perforation. Chronic colonic pseudoobstruction is a syndrome of many causes. The prognosis of patients with chronic colonic pseudoobstruction is much better than that of generalized chronic intestinal pseudoobstruction, because the patients become asymptomatic with appropriate operations. The pathogenesis of acute colonic pseudoobstruction and several types of chronic colonic pseudoobstruction is not known. Further investigations should include bacteriologic study, histopathologic studies (examinations of smooth muscle and myenteric plexus), and examination of extrinsic nerves of the colon. With these approaches, a better understanding of the pathogenesis of these syndromes will be achieved. MH - *Colonic Diseases/ETIOLOGY/PHYSIOPATHOLOGY/THERAPY ; Human ; *Intestinal Pseudo-Obstruction/ETIOLOGY/PHYSIOPATHOLOGY/THERAPY ; Review ; Support, U.S. Gov't, P.H.S. SO - Clin Gastroenterol 1986 Oct;15(4):745-62 7 UI - 87031357 AU - Mayer EA ; Schuffler MD ; Rotter JI ; Hanna P ; Mogard M TI - Familial visceral neuropathy with autosomal dominant transmission. AB - This report describes a family with a visceral neuropathy without extraintestinal manifestations transmitted over at least four generations in an autosomal dominant manner. Four of 7 living patients underwent extensive evaluation including histology, radiography, gastric emptying and secretory studies, esophageal and jejunal manometry, and measurements of plasma levels of gastrointestinal hormones. The only characteristic radiologic abnormality in 7 patients was dilatation of jejunum and ileum. Gastric emptying studies were normal in 2 patients, whereas 2 others showed accelerated emptying of liquids either alone or in combination with grossly delayed solid emptying. Manometry of the esophagus and proximal small intestine and gastric secretory studies were normal. Histologic studies showed hypertrophy of the smooth muscle, a markedly reduced number of argyrophilic neurons, and degenerative changes of argyrophilic neurons and nerve fibers but without Schwann cell proliferation, intranuclear inclusions, or inflammatory cells. This appears to be a familial visceral neuropathy characterized by distinct involvement of the jejunum and ileum as defined radiographically, histology different from that of two previously described forms of familial visceral neuropathy, autosomal dominant transmission, and no evidence for extraintestinal neurologic manifestations. MH - Adult ; Child ; Esophagus/PHYSIOPATHOLOGY ; Female ; Gastric Emptying ; Gastrointestinal System/PHYSIOPATHOLOGY ; Human ; Intestinal Pseudo-Obstruction/*FAMILIAL & GENETIC/PATHOLOGY/ PHYSIOPATHOLOGY ; Intestines/PATHOLOGY ; Male ; Manometry ; Middle Age ; Pedigree SO - Gastroenterology 1986 Dec;91(6):1528-35 8 UI - 87009750 AU - Freilich HS ; Chopra S ; Gilliam JI TI - Acute colonic pseudo-obstruction or Ogilvie's syndrome. Report of two cases treated with colonoscopic decompression and review of the literature. AB - Acute colonic pseudo-obstruction (ACP), or Ogilvie's syndrome, is a disorder characterized by massive dilatation of the colon, and typically occurs in the critically ill or post-operative patient. The clinical presentation may be impossible to distinguish from mechanical causes of colonic obstruction. Its importance is reflected in an overall mortality of up to 30%, perforation of the cecum occurring in 14.8% of patients with a reported mortality of up to 46%. Medical therapy has had variable results. Tube cecostomy or other operative interventions can lead to much morbidity and mortality in the critically ill patient. Colonoscopy recently has proven to be highly effective in achieving colonic decompression as well as excluding a mechanical etiology for obstruction and poses minimal risk to the patient. Colonoscopy should be reserved for patients who show progressive cecal dilatation or who deteriorate clinically despite aggressive medical therapy. We report two patients with ACP treated with colonoscopy and review the literature. MH - Acute Disease ; Aged ; Case Report ; Colonic Pseudo-Obstruction/ RADIOGRAPHY/*THERAPY ; *Colonoscopy ; Decompression ; Human ; Intestinal Pseudo-Obstruction/*THERAPY ; Male SO - J Clin Gastroenterol 1986 Aug;8(4):457-60 9 UI - 86321149 AU - Wallin G ; Cassuto J ; H:ogstr:om S ; Rimb:ack G ; Fax:en A ; Tollesson PO TI - Failure of epidural anesthesia to prevent postoperative paralytic ileus. AB - This study used radiopaque markers and serial abdominal radiographs to assess the effect of epidural anesthesia on postoperative colonic ileus. Epidural anesthesia did not result in significantly faster return of propulsive motility in the colon after surgery as compared with control (P greater than 0.05). In addition, no significant difference was seen between the groups in colonic transit time and time for the first passage of gas and feces. The level of inhibition of sympathetic efferent nerves to the abdominal cavity was assessed by repeated measurements of blood glucose levels during the first postoperative day. Blood glucose levels were found to be significantly lower in the epidural group, demonstrating an inhibition of efferent sympathetic nerves below the level of T-5. Results show lack of effect of continuous epidural anesthesia in the prevention of postoperative paralytic ileus and suggest that mechanisms other than spinal reflexes play a major part in the development and maintenance of intestinal paralysis. MH - *Anesthesia, Epidural ; Anesthesia, General ; Blood Glucose/ ANALYSIS ; Cholecystectomy ; Colon/DRUG EFFECTS ; Fentanyl ; Gastrointestinal Motility/DRUG EFFECTS ; Human ; Intestinal Obstruction/*PREVENTION & CONTROL ; Intestinal Pseudo-Obstruction/ *PREVENTION & CONTROL ; Pain ; Postoperative Complications/ *PREVENTION & CONTROL ; Support, Non-U.S. Gov't ; Time Factors SO - Anesthesiology 1986 Sep;65(3):292-7 10 UI - 86319776 AU - Raptopoulos V ; Smith EH ; Cummings T ; Silva W ; Karellas A TI - Bile-duct dilatation after laparotomy: a potential effect of intestinal hypomotility. AB - Dilatation of unobstructed extrahepatic bile ducts was observed in patients with conditions associated with intestinal hypomotility. For further investigation of this association, a prospective study was undertaken in which the common hepatic duct was measured in 15 patients before and 1 day after laparotomy, when all patients had postoperative paralytic ileus. A statistically significant (p less than 0.01) increase in the mean diameter of the hepatic duct was observed postoperatively. When compared with the preoperative measurement, the mean diameter of the duct almost doubled, from 3.3 to 5.9 mm. This phenomenon may be due to persistent contraction of the sphincter of Oddi that occurs when intestinal hypomotility eliminates the stimuli for cholecystokinin release. MH - Adult ; Aged ; Female ; Gastrointestinal Motility ; Hepatic Duct, Common/*PATHOLOGY ; Human ; Intestinal Pseudo-Obstruction/ PATHOLOGY ; Laparotomy ; Male ; Middle Age ; Postoperative Complications SO - AJR 1986 Oct;147(4):729-31 11 UI - 86275894 AU - Camilleri M ; Brown ML ; Malagelada JR TI - Impaired transit of chyme in chronic intestinal pseudoobstruction. Correction by cisapride. AB - Chronic intestinal pseudoobstruction is a clinical syndrome whose pathophysiology, objective diagnosis, and treatment are poorly understood. We investigated 8 patients with this syndrome in whom intestinal dysmotility was established manometrically by two or more of the following criteria: abnormal configuration or propagation of interdigestive motor complexes, sustained incoordinate pressure activity, non-propagated bursts of phasic pressure activity, and failure of a solid-liquid meal to induce a fed pattern. To establish the functional impairment and region of the gut primarily affected by the disease, we quantified radio-scintigraphically the gastrointestinal transit of the solid (131I-fiber) and liquid (99 mTc-DTPA) components of a meal. Our techniques allowed us to quantify separately gastric emptying and pylorus-to-cecum transit. Furthermore, we evaluated the effects of a new prokinetic agent, cisapride. Gastric emptying times in pseudoobstruction were not significantly delayed; however, transit times through the small bowel (t1/2) were markedly prolonged [solids, 235 +/- 43 min (mean +/- SEM) vs. 138 +/- 25 controls, p less than 0.05; liquids, 310 +/- 67 vs. 181 +/- 28 controls, p = 0.07]. Cisapride was effective in reducing the delayed intestinal transit time to within the normal range (delta solids = -115 +/- 25 min; delta liquids = -146 +/- 71 min; p less than 0.05 for both). These studies suggest that intestinal dysmotility in this group of patients with pseudoobstruction was associated with delayed small bowel transit of radiolabeled solid and liquid components of chyme. Cisapride can restore to normal the delayed transit, indicating that it may potentially correct the impaired propulsive activity in the small bowel of these patients. MH - Adult ; DTPA/DIAGNOSTIC USE ; Eating ; Female ; Gastric Emptying ; Gastrointestinal Motility/*DRUG EFFECTS ; Human ; Intestinal Obstruction/*PHYSIOPATHOLOGY ; Intestinal Pseudo-Obstruction/DRUG THERAPY/*PHYSIOPATHOLOGY ; Iodine Radioisotopes/DIAGNOSTIC USE ; Male ; Middle Age ; Piperidines/*THERAPEUTIC USE ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. ; Technetium/ DIAGNOSTIC USE SO - Gastroenterology 1986 Sep;91(3):619-26 12 UI - 86257930 AU - Warmenhoven PG ; Butzelaar RM ; Keeman JN TI - Acute pseudo-obstruction of the colon. AB - Five patients were treated for pseudo-obstruction of the colon. The symptoms, diagnostic procedures and treatment of Ogilvie's syndrome are discussed. A definitive diagnosis can be established only at laparotomy when no mechanical obstruction is found to be present. Progression of ileus and signs of peritonitis constitute an indication for laparotomy. Delay in operative therapy implies the risk of (coecal) perforation with increased mortality. Coecostomy is an adequate therapy that spares the patient a second procedure for closure of a colostomy. MH - Aged ; Case Report ; Colonic Diseases/*PATHOLOGY ; Female ; Human ; Intestinal Obstruction/*PATHOLOGY ; Intestinal Pseudo-Obstruction/*PATHOLOGY ; Male ; Middle Age SO - Neth J Surg 1986 Jun;38(3):73-5 13 UI - 86248521 AU - Gottlieb SH ; Schuster MM TI - Dermatoglyphic (fingerprint) evidence for a congenital syndrome of early onset constipation and abdominal pain. AB - Chronic idiopathic constipation and abdominal pain are the most common gastrointestinal symptoms but their cause is rarely determined; therefore, they usually are called functional. To determine if congenital factors play a role in these disorders, we examined dermatoglyphic (fingerprint) patterns, a congenital marker, in 155 consecutive patients with gastrointestinal complaints. Sixty-four percent of patients with constipation and abdominal pain before age 10 yr had one or more digital arches, compared with 10% of patients without constipation and abdominal pain (p less than 0.001). Seventy percent of constipated patients with arches had the onset of symptoms before age 10 yr compared with 23% of constipated patients without arches (p less than 0.001) and 14% of patients with symptoms other than constipation (p less than 0.001). Compared with an age- and sex-matched sample of patients without arches, patients with arches had a higher prevalence of constipation and abdominal pain before age 10 (p = 0.003), were more likely (p less than 0.001) to have chronic intestinal pseudoobstruction (an organic disorder), and were less likely (p = 0.013) to have irritable bowel syndrome (a functional disorder). Identification of a congenital marker, digital arches, associated with early onset constipation and abdominal pain may help to differentiate a congenital organic syndrome from functional disorders such as the irritable bowel syndrome. MH - *Abdomen ; Adult ; Age Factors ; Case Report ; Child ; Colitis, Ulcerative/DIAGNOSIS ; Comparative Study ; Constipation/ *CONGENITAL/DIAGNOSIS ; Crohn Disease/DIAGNOSIS ; *Dermatoglyphics ; Female ; Human ; Intestinal Pseudo-Obstruction/ DIAGNOSIS ; Male ; Middle Age ; Pain/*CONGENITAL/DIAGNOSIS ; Statistics ; Syndrome SO - Gastroenterology 1986 Aug;91(2):428-32 14 UI - 86145295 AU - Kunst:y:r I TI - Paresis of peristalsis and ileus lead to death in lactating mice. AB - Based on the examination of 45 dead and 5 moribund female mice during a 2-year period, we are able to describe a new disease entity: ileus of the small intestine in lactating mice caused by a paresis of peristalsis. Diarrhoea was not observed and inflammation and infectious agents were not found. Females were affected during the 2nd week of their first lactation. The condition may have a mortality rate as high as 40%. It is assumed that exhaustion (calcium, glucose, etc.) is the cause of this condition. Consequently, the development of a dietary supplement or of a special diet for lactating mice may prove beneficial in preventing this disease. Endogenic (Clostridia) or exogenic toxic components may also play a role. MH - Animal ; Female ; *Gastrointestinal Motility ; Intestinal Obstruction/MORTALITY/PATHOLOGY/*VETERINARY ; Intestinal Pseudo-Obstruction/MORTALITY/PATHOLOGY/VETERINARY ; *Lactation ; Mice ; *Peristalsis ; Pregnancy ; Rodent Diseases/MORTALITY/ *PATHOLOGY SO - Lab Anim 1986 Jan;20(1):32-5 15 UI - 86109367 AU - Krishnamurthy S ; Schuffler MD ; Belic L ; Schweid AI TI - An inflammatory axonopathy of the myenteric plexus producing a rapidly progressive intestinal pseudoobstruction. AB - A previously well 39-yr-old man presented with a 4-wk history of abdominal pain, nausea, vomiting, and weight loss. An upper gastrointestinal examination showed retained food in the stomach and duodenal dilatation. A radioisotope meal showed little gastric emptying; esophageal manometry was normal. Because of persistent symptoms, a duodenojejunostomy was done. However, the patient remained symptomatic and after an episode of profuse vomiting, aspirated and died 10 wk after initial presentation. At autopsy, no tumor was found. Hematoxylin and eosin stains throughout the gastrointestinal tract showed many lymphocytes and plasma cells within the myenteric plexus. Silver stains showed the argyrophilic and argyrophobic neurons to be normal, but axons showed beading, fragmentation, and dropout in all areas. We therefore concluded the following: intestinal pseudoobstruction can be caused by an inflammatory neuropathy of the myenteric plexus, not associated with a distant carcinoma, and this process produced an axonopathy while sparing neuron bodies. MH - Adult ; Axons/*PATHOLOGY ; Case Report ; Duodenal Diseases/ *PATHOLOGY ; Duodenum/PATHOLOGY ; Human ; Intestinal Obstruction/ *PATHOLOGY ; Intestinal Pseudo-Obstruction/ETIOLOGY/*PATHOLOGY ; Lymphocytes/PATHOLOGY ; Male ; Myenteric Plexus/*PATHOLOGY ; Neuritis/COMPLICATIONS/*PATHOLOGY ; Support, U.S. Gov't, P.H.S. ; Time Factors SO - Gastroenterology 1986 Mar;90(3):754-8 16 UI - 86107699 AU - Vanek VW ; Al-Salti M TI - Acute pseudo-obstruction of the colon (Ogilvie's syndrome). An analysis of 400 cases. AB - This study analyzes 400 cases of acute pseudo-obstruction of the colon (Ogilvie's syndrome). Seven cases were reported at St. Elizabeth Hospital Medical Center between October 1982 and February 1985; 393 cases were reported in the literature from 1970-1985. Ogilvie's syndrome is most commonly reported in patients in the sixth decade, and is more predominant in men. It is caused by an unknown disturbance to the autonomic innervation of the distal colon, and is associated with different conditions. Plain abdominal roentgenogram is the most useful diagnostic test. If the cecal diameter is 12 cm or greater, or conservative management is unsuccessful, colonoscopic or operative decompression is needed. The mode of treatment, age, cecal diameter, delay in decompression, and status of the bowel significantly influence the mortality rate, which is approximately 15 percent with early appropriate management, compared with 36 to 44 percent in perforated or ischemic bowel. MH - Adolescence ; Adult ; Age Factors ; Aged ; Cecum/PHYSIOPATHOLOGY ; Colonic Diseases/ETIOLOGY/MORTALITY/PHYSIOPATHOLOGY/*SURGERY ; Colonoscopy ; Female ; Human ; Intestinal Obstruction/*SURGERY ; Intestinal Pseudo-Obstruction/ETIOLOGY/MORTALITY/PHYSIOPATHOLOGY/ *SURGERY ; Male ; Middle Age ; Sex Factors SO - Dis Colon Rectum 1986 Mar;29(3):203-10 17 UI - 86083036 AU - Leon SH ; Schuffler MD ; Kettler M ; Rohrmann CA TI - Chronic intestinal pseudoobstruction as a complication of Duchenne's muscular dystrophy. AB - We report a case of Duchenne's muscular dystrophy complicated by intestinal pseudoobstruction. The patient had recurrent attacks of nausea, vomiting, and abdominal distention for many years, and abdominal films repeatedly showed a dilated and fluid-filled small intestine and colon. Barium studies showed an esophageal diverticulum, reduced esophageal and gastric motility, and a dilated small bowel and colon. Pathologically, the entire gastrointestinal tract had smooth muscle fibrosis, but this was most marked in the esophagus and stomach. We conclude that Duchenne's muscular dystrophy may involve intestinal smooth muscle and produce pseudoobstruction. MH - Adolescence ; Case Report ; Esophagus/PATHOLOGY ; Human ; Intestinal Obstruction/*ETIOLOGY ; Intestinal Pseudo-Obstruction/ *ETIOLOGY/PATHOLOGY ; Intestines/PATHOLOGY ; Male ; Muscle, Smooth/PATHOLOGY ; Muscular Dystrophy/*COMPLICATIONS/FAMILIAL & GENETIC ; Stomach/PATHOLOGY SO - Gastroenterology 1986 Feb;90(2):455-9 18 UI - 86262135 AU - Berglund B ; Kock NG ; Myrvold HE TI - Volume capacity and pressure characteristics of the continent cecal reservoir. AB - In 11 patients with continent cecostomy, the volume capacity and pressure characteristics of the cecal reservoir were studied at several intervals postoperatively. The reservoir volume stabilized at 400 milliliters four months postoperatively. The basal pressure increased during filling to approximately 9 centimeters of H2O. Pressure waves appeared at all filling volumes in the reservoir but increased in frequency and amplitude with increasing volume. The area underneath the pressure waves was calculated and used as a quantitative measurement of the motor activity. In this manner, a significant increase in motor activity was seen with increasing reservoir volume, although no significant change of motor activity was seen with increasing time after operation. Data from the cecal reservoir were compared with corresponding data from the ileal reservoir obtained in a previous study at our laboratory. This comparison showed a smaller volume capacity and higher basal pressure in the cecal reservoir at identical filling volumes. The motor activity in the cecal reservoir was 20 times greater than that in the ileal reservoir. Thus, the cecal reservoir has a low adaptability to distension compared with the ileal reservoir. MH - Adolescence ; Adult ; Cecum/*PHYSIOLOGY/SURGERY ; Comparative Study ; Female ; Human ; Ileostomy ; Ileum/PHYSIOLOGY ; Male ; Middle Age ; Postoperative Period ; Pressure ; Support, Non-U.S. Gov't SO - Surg Gynecol Obstet 1986 Jul;163(1):42-8 19 UI - 86248864 AU - Hall JB ; Fox JS ; Thomason MH TI - Pseudoobstruction of the colon. AB - A previously unreported complication of extraperitoneal node dissection, pseudoobstruction of the colon, is described as a case report, and its etiology and treatment are discussed. MH - Adult ; Carcinoma, Squamous Cell/SURGERY ; Case Report ; Cecum/ RADIOGRAPHY ; Cervix Neoplasms/SURGERY ; Colon/*RADIOGRAPHY ; Colonoscopy ; Decompression ; Female ; Human ; Intestinal Obstruction/*ETIOLOGY/RADIOGRAPHY/THERAPY ; Intubation, Gastrointestinal ; Lymph Node Excision ; Neoplasm Staging ; Postoperative Complications/ETIOLOGY SO - Gynecol Oncol 1986 Jul;24(3):381-5 20 UI - 86180369 AU - Goldstein SD ; Salvati EP ; Rubin RJ ; Eisenstat TE TI - Tube cecostomy with cecal extraperitonealization in the management of obstructing left sided carcinoma of the large intestine. AB - The technique of tube cecostomy has enabled us to manage safely and expeditiously patients with obstruction of the large intestine secondary to left sided carcinoma. Extraperitonealization of the cecum and insertion of a large bore catheter are each critical to the success of this modality. MH - Catheterization ; Cecum/*SURGERY ; Human ; Intestinal Neoplasms/ *SURGERY ; Intestinal Obstruction/*SURGERY ; Methods ; Peritoneum/ *SURGERY ; Suture Technics SO - Surg Gynecol Obstet 1986 Apr;162(4):379-80 21 UI - 86121717 AU - Casola G ; Withers C ; vanSonnenberg E ; Herba MJ ; Saba RM ; Brown RA TI - Percutaneous cecostomy for decompression of the massively distended cecum. AB - Massive dilatation of the cecum developed in an elderly man following admission for an acute episode of upper gastrointestinal hemorrhage complicated by myocardial infarction, ventricular fibrillation, and pulmonary edema. A diagnosis of pseudo-obstruction was made. After an unsuccessful attempt at colonoscopy, percutaneous cecostomy was performed under computed tomographic guidance, using trocar technique. The cecal distention resolved and did not recur. Percutaneous cecostomy is an alternative to colonoscopy and to surgical cecostomy in the treatment of massive cecal distention. MH - Aged ; Case Report ; Catheterization ; Cecum/RADIOGRAPHY/*SURGERY ; Human ; Intestinal Obstruction/RADIOGRAPHY/*SURGERY ; Male ; Tomography, X-Ray Computed SO - Radiology 1986 Mar;158(3):793-4 22 UI - 86078988 AU - Rosenberg L ; Gordon PH TI - Tube cecostomy revisited. AB - A retrospective review of 59 tube cecostomies, performed between 1971 and 1981, was undertaken to evaluate current operative indications, outcome and associated morbidity. Tube cecostomy was performed as a complementary procedure in 81.4% of cases; in the other 18.6%, it represented either the only operative intervention or the initial stage of a two-stage procedure. Complications included local infection in 32% of cases, peri-catheter leak in 25%, skin excoriation in 24% and pain in 12%. Catheters remained in place an average of 14 days, but function was adequate in only 40% of cases. Cecal drainage persisted from 24 hours to 90 days after the tube was removed. Two additional procedures were required to close persistent cecal fistulas. The authors conclude that the high morbidity associated with this procedure militates against its routine use. Decompression by cecostomy may be inadequate for treating acute colonic obstruction. MH - Adolescence ; Adult ; Aged ; Cecal Diseases/ETIOLOGY ; Cecum/ *SURGERY ; Colonic Diseases/*SURGERY ; Female ; Human ; Intestinal Fistula/ETIOLOGY ; Intestinal Obstruction/*SURGERY ; Intubation/*METHODS ; Male ; Megacolon/SURGERY ; Middle Age ; Postoperative Complications/ETIOLOGY ; Retrospective Studies ; Surgical Wound Infection/ETIOLOGY SO - Can J Surg 1986 Jan;29(1):38-40