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bowel adhesions

Bram Verstockt, Marc Ferrante, Séverine Vermeire, Gert Van Assche
The advent of anti-TNF agents has dramatically changed the treatment algorithms for IBD in the last 15 years, but primarily and more importantly secondary loss of response is often observed. Fortunately , new treatment options have been actively explored and some have already entered our clinical practice. In the class of anti-cytokine agents, the anti-IL12/IL23 monoclonal antibodies (mAbs) have entered clinical practice with the anti-p40 mAb ustekinumab in Crohn's disease (CD). Also, more selective anti-IL23 agents (anti-p19) have shown efficacy and are being further developed, in contrast to agents inhibiting IL-17 downstream which have failed in clinical trials despite their clear efficacy in psoriasis (Verstockt et al...
March 19, 2018: Journal of Gastroenterology
Pallavi Gurung, Suhrid Banskota, Nikita Katila, Jaya Gautam, Tara Man Kadayat, Dong-Young Choi, Eung Seok Lee, Tae Cheon Jeong, Jung-Ae Kim
The pathogenesis of inflammatory bowel disease (IBD) is associated with production of immense pro-inflammatory cytokines including TNF-α. Once generated, TNF-α stimulates production of various pro-inflammatory cytokines and disrupts mucosal barrier by inducing inflamed mucosal epithelial cell death. In the present study, we investigated inhibitory effects of TI-1-162, a hydroxyindenone derivative, against TNF-α-induced and TNBS-induced colon inflammation. TI-1-162 showed inhibitory effect on the TNF-α-induced adhesion of U937 monocytic cells to HT-29 colonic epithelial cells (IC50 = 0...
March 16, 2018: European Journal of Pharmacology
David Asuzu, Kevin Y Pei, Kimberly A Davis
BACKGROUND: Small bowel obstruction is common and often requires surgical management. Simple preoperative models are lacking to predict post-operative complications after surgical management of adhesive small bowel obstruction. METHODS: We retrospectively analyzed data from 15,036 patients who underwent open lysis of adhesions for small bowel obstruction from 2005 to 2013 using the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database...
March 6, 2018: American Journal of Surgery
John O Hwabejire, Daniel D Tran, Terrence M Fullum
The management of adhesive small bowel obstruction (ASBO) has evolved from "the sun should not rise and set on a small bowel obstruction", implying mandatory immediate surgical exploration to selective non-operative management. Not every patient with adhesive small bowel obstruction meets criteria for non-operative management and treating all comers the same way can lead to catastrophic outcomes. Water Soluble Contrast Medium (WSCM) has important diagnostic and therapeutic utility in the management of ASBO and should be employed ab initio...
March 7, 2018: American Journal of Surgery
Hiroshi Tamura, Tatsuo Kanda, Tadasu Chida, Hitoshi Kameyama, Ukihide Tateishi, Toshifumi Wakai, Makoto Naito
BACKGROUND: Pneumatosis cystoides intestinalis (PCI) is a rare disease characterized by multiple gas-filled cysts in the intestinal wall and is associated with various comorbidities. We report herein a case of intractable paralytic ileus caused by primary PCI. CASE PRESENTATION: A 73-year-old man visited out hospital complaining of abdominal pain and vomiting. He had been hospitalized twice for intestinal obstruction in the past 2 months. Based on his history of appendectomy, mechanical bowel obstruction caused by adhesion was diagnosed, and the patient underwent surgery...
March 14, 2018: Surgical Case Reports
H Roman, M Ballester, J Loriau, M Canis, P A Bolze, J Niro, S Ploteau, C Rubod, C Yazbeck, P Collinet, B Rabischong, B Merlot, X Fritel
The article presents French guidelines for surgical management of endometriosis. Surgical treatment is recommended for mild to moderate endometriosis, as it decreases pelvic painful complaints and increases the likelihood of postoperative conception in infertile patients (A). Surgery may be proposed in symptomatic patients with ovarian endometriomas which diameter exceeds 20mm. Cystectomy allows for better postoperative pregnancy rates when compared to ablation using bipolar current, as well as for lower recurrences rates when compared to ablation using bipolar current or CO2 laser...
March 8, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
William Syrmis, Russell Richard, Sue Jenkins-Marsh, Siew C Chia, Phillip Good
BACKGROUND: Malignant bowel obstruction (MBO) is a common problem in patients with intra-abdominal cancer. Oral water soluble contrast (OWSC) has been shown to be useful in the management of adhesive small bowel obstruction in identifying patients who will recover with conservative management alone and also in reducing the length of hospital stay. It is not clear whether the benefits of OWSC in adhesive small bowel obstruction are also seen in patients with MBO. OBJECTIVES: To determine the reliability of OWSC media and follow-up abdominal radiographs in predicting the success of conservative treatment in resolving inoperable MBO with conservative management...
March 7, 2018: Cochrane Database of Systematic Reviews
Chaitanya Allamneni, Krishna Venkata, Huifeng Yun, Fenglong Xie, Lindsey DeLoach, Talha A Malik
Background: Vedolizumab (VDZ), an adhesion molecule inhibitor and infliximab (IFX), a tumor necrosis factor (TNF) blocker, are both approved as first-line induction agents in moderately to severely active ulcerative colitis (UC). However, there are no head-to-head studies comparing the relative effectiveness of the two agents. Here we provide a real-world comparison of these two agents. Methods: We conducted an ambidirectional cohort study of adult UC patients seen at our tertiary inflammatory bowel disease (IBD) center from 2012 to 2017...
February 2018: Gastroenterology Research
Siyu Liu, Mugen Dai, Bin Ye, Zhigang Zhao, Yang Shi, Lirong Peng
RATIONALE: Diaphragmatic Hernia is rare as complication of Colonoscopy. Diaphragmatic hernia as a complication of colonoscopy has been reported only few cases. Additionally, it is often misdiagnosed as other disease by clinicians due to their lack of related knowledge, which delays diagnosis of Diaphragmatic hernia and thus exacerbates the prognosis. PATIENT CONCERNS: We report the case of a 66-year-old man with fecal occult blood. In the case, sudden epigastric pain after colonoscopy owing to diaphragmatic hernia in a left hemidiaphragm...
January 2018: Medicine (Baltimore)
Qingjuan Shang, Qiankun Geng, Xuebing Zhang, Hongfang Xu, Chunbao Guo
This study was conducted to assess the clinical advantages of early enteral nutrition (EEN) in pediatric patients who underwent surgery with gastrointestinal (GI) anastomosis.EEN has been associated with clinical benefits in various aspect of surgical intervention, including GI function recovery and postoperative complications reduction. Evaluable data documenting clinical advantages with EEN for pediatric patients after surgery with GI anastomosis are limited.We retrospectively reviewed the medical records of 575 pediatric patients undergoing surgical intervention with GI anastomosis...
March 2018: Medicine (Baltimore)
Huachan Gan, Jinxuan Lin, Zhi Jiang, Qicheng Chen, Lixing Cao, Zhiqiang Chen
BACKGROUND: Most patients who undergo abdominal surgery recover bowel movements within a week; however, some suffer prolonged intestinal paralysis or postoperative ileus (POI) leading to complications, such as infection and intestinal adhesions, which can extend hospitalization and increase readmission rates, and consequently increasing healthcare costs. Chinese medicine is effective for accelerating the recovery of gastrointestinal function after abdominal surgery. Xiangbin prescription (XBP) is the standard prescription for this purpose in our hospital; however, randomized controlled trials of it have not yet been conducted...
February 27, 2018: Trials
Hrishikesh P Salgaonkar, Ramya Ranjan Behera, Pradeep Chandra Sharma, Avinash Katara, Deepraj S Bhandarkar
Background: Malfunction of continuous ambulatory peritoneal dialysis (CAPD) catheters is a frequent complication and has traditionally been treated with a laparotomy. We present our experience with minimally invasive surgical (laparoscopic and thoracoscopic) salvage of CAPD catheters. Materials and Methods: Between October 2003 and June 2013, 19 patients (13 males and 6 females with a mean age of 37 years [range 28-64]) underwent minimally invasive laparoscopic salvage of malfunctioning CAPD catheters...
February 27, 2018: Journal of Minimal Access Surgery
Geom Seog Seo, Sung Hee Lee
The treatment of inflammatory bowel disease has evolved with the development of anti-TNF agents. In spite of long-term effectiveness, many patients do not respond or no longer responds to these drugs. Therefore, the development of new drugs that act on different inflammatory pathways has become necessary. Vedolizumab, a gut-specific biological agent, inhibits interaction α4β7 integrin with mucosal addressin cell adhesion molecule-1 without inhibiting systemic immune responses. Long-term vedolizumab therapy in patients with Crohn's disease and ulcerative colitis was safe and effective...
February 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Haruna Nakamura, Toh Yoon Ezekiel Wong
For postgastrostomy patients suffering from adhesive small bowel obstruction, transgastric decompression with a multiluminal nasojejunal tube is an effective and more comfortable alternative to conventional nasal tubing using an ileus tube.
February 2018: Clinical Case Reports
Yoshiaki Ota, Masaaki Andou, Ikuko Ota
Deep infiltrating endometriosis (DIE) is the most severe form of endometriosis. It causes chronic pelvic pain, severe dysmenorrhea, deep dyspareunia, dyschezia, and dysuria, markedly impairing the quality of life of women of reproductive age. A number of randomized controlled trials on surgical and medical treatments to reduce the pain associated with endometriosis have been reported, but few have focused on this in DIE. DIE causes not only pain but also functional invasion to the urinary organs and bowel, such as hydronephrosis and bowel stenosis...
February 14, 2018: Asian Journal of Endoscopic Surgery
Wu Seong Kang, Yun Chul Park, Young Goun Jo, Jung Chul Kim
Purpose: This study aimed to investigate the incidence and risk factors of early postoperative small bowel obstruction (EPSBO) after laparotomy for trauma patients. Methods: From 2009 to 2016, consecutive patients who had undergone laparotomy for trauma were retrospectively evaluated. EPSBO was defined as the presence of signs and symptoms of obstruction between postoperative days 7 and 30, or obstruction occurring anytime within 30 days and lasting more 7 days...
February 2018: Annals of Surgical Treatment and Research
Hidemitsu Nakagawa, Satoru Sasagawa, Kazuyuki Itoh
Sodium butyrate (SB), a short chain (C-4) saturated fatty acid, is present in the human bowel at increased concentrations (~2 mM) as a food metabolite. It has been demonstrated that SB exerts an anti-tumor effect as a histone deacetylase inhibitor; however, its precise mechanism of action remains to be elucidated. The present study focused on the mechanisms underlying the effects of SB on glioblastoma (GB) cell proliferation, motility and invasion. In human GB A172 cells, flow cytometry and a Boyden chamber assay demonstrated that physiological concentrations of SB (0...
February 2018: Oncology Letters
Daniel Fiumecaldo, Lauren Buck
Chilaiditi's sign is a radiological finding that occurs when the small or large intestine is positioned superior to the liver in the sub-diaphragmatic space. This is typically an asymptomatic radiological sign, but when symptoms occur, e.g., abdominal pain, nausea, emesis, it is termed Chilaiditi's syndrome. Currently, majority of the cases of Chilaiditi's syndrome, described in the literature, requiring operative intervention are due to large bowel obstruction or colonic volvulus. The following is a single case report of a patient presenting to Keesler Medical Center in Biloxi, Mississippi...
February 5, 2018: Military Medicine
Satoshi Nishiwada, Shinji Nakamura, Tetsuya Tanaka, Yuki Kirihataya, Daiki Nezu, Nobuhiro Sawa, Naoki Fujita, Haruka Ikegami, Atsushi Yoshimura
INTRODUCTION: Entero-enteric fistulas are rare complications that occur in patients with inflammatory bowel disease and other intestinal diseases. In this report, we present an ileo-ileal fistula accompanied by severe malnutrition caused by strangulated ileus surgery while preserving the ischemic ileum in a very elderly patient. CASE PRESENTATION: A 90-year-old woman underwent emergency surgery without bowel resection for strangulated ileus in another hospital. Minor abdominal pain and slight fever persisted after surgery...
January 27, 2018: International Journal of Surgery Case Reports
Ryohei Takei, Ichiro Onishi, Ryosuke Zaimoku, Naoki Makita, Yasumichi Yagi, Masato Kayahara
BACKGROUND Primary small bowel cancer is a rare malignancy; the common histopathological types are carcinoid and adenocarcinoma. Inflammatory bowel diseases and familial adenomatous polyposis are known risk factors for small bowel cancer. Additionally, cases of surgery-induced small bowel adenocarcinoma are sometimes reported after ileostomy. CASE REPORT A 84-year-old woman, who had undergone ileotransversostomy for intestinal obstruction due to postoperative adhesion following appendectomy at the age of 31 years, was referred to our hospital for further examination after experiencing abdominal pain in the right lower quadrant for 2 weeks...
February 6, 2018: American Journal of Case Reports
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