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At least 487 records · Page 27Linked to original sources
PubMed2005

[Clinical results of intestinal and multivisceral transplantation at the Charité, Berlin. A case series].

BACKGROUND AND OBJECTIVE: Intestinal transplantation (ITx) is the only causal therapy of short bowel syndrome (SBS). Long-term survival after ITx has been improved significantly during the last years. The experience with ITx at the Charite, Campus Virchow Klinikum, are described and discussed. PATIENTS AND METHODS: Twelve isolated ITx and one multivisceral transplantation (including stomach, pancreatodudenal complex, small intestine, liver, ascending colon, right kidney, and adrenal gland) were performed. Mean recipient age was 37.7+/-10.6 yrs (median: 35 yrs; range: 27 - 58 yrs; M:F = 8:5). All patients had irreversible SBS (0 - 30 cm residual bowel length; mean: 11.8+/-11.4 cm; median: 13 cm). RESULTS: 6-months and 1-year patient and graft survival were 85 % (11/13) and 77 % (10/13), respectively. Reasons for graft loss and patient death were necrotizing enterocolitis, severe, muromonab-resistent, acute rejection, and graft ischemia due to complex coagulopathy. All other patients had good long-term outcome. They received enteral nutrition at six hours after operation and were persistently off total parenteral nutrition (TPN) by week two after ITx. CONCLUSION: ITx as established in our centre, with 1-year-patient and graft survival rates of 77 %, reflects current international standard. ITx is complementary to conservative and other operative methods of treating SBS. Referral and indication criteria need wider dissemination to prevent life-threatening complications of TPN.

Adolescent↗
PubMed1985

Persistence of colitis in Hirschsprung's disease.

Enterocolitis, which is associated frequently with Hirschsprung's disease in the neonatal period, can be prolonged. Recurrence of symptoms has been reported even after surgical correction. We present a neonate with Hirschsprung's disease who developed enterocolitis, and in whom evidence of acute large bowel inflammation persisted until she was 16 months of age.

Colostomy↗
PubMed1997

Neutropenic enterocolitis in adult leukemias.

Neutropenic enterocolitis is a frequent autopsy finding in adult patients with acute leukemias. The predisposing factors other than neutropenia are not clear. There are also contradictions about treatment. Therefore, this entity still presents a diagnostic and therapeutic dilemma for clinicians. This retrospective study was performed to determine the incidence of neutropenic enterocolitis in adult leukemic patients, to examine the possible risk factors, clinical characteristics and treatment outcome. The pathogenesis is also discussed considering clinical and laboratory findings of the patients. The incidence of neutropenic enterocolitis was 6.5% for acute myeloid leukemia and 4.6% for acute lymphoblastic leukemia. The mean absolute neutrophil count at diagnosis was 48/mm3 (median: 0/mm3). The median duration of severe neutropenia (absolute neutrophil count < or = 500/mm3) on follow-up before the diagnosis was 32 days. Thirteen out of 20 patients had received antineoplastic drugs within the last 12 days, but 2 had not. Fourteen patients had signs of peritoneal irritation and 3 of them underwent surgery. The others received supportive measures, i.e. bowel rest, intravenous fluids, combinations of wide spectrum antibiotics, transfusions, hemodynamic supports and nasogastric decompression, if necessary. All 3 patients who underwent surgery survived, whereas only 1 of the 11 who received other treatments did. Six patients without signs of peritonitis were treated with antibiotics and the mentioned supportive measures. Four survived, but the others died due to sepsis. In conclusion, considering some recent reports that stated good outcome with conservative measures in the presence or absence of peritonitis, there is still debate regarding the optimal choice of treatment. The importance of early diagnosis cannot be overemphasized. Signs of peritoneal irritation indicate a life threatening condition. Surgery can be performed successfully in such patients. Long duration of neutropenia may be an important risk for neutropenic enterocolitis.

Acute Disease↗
PubMed2005

Neutropenic enterocolitis (typhlitis) associated with infectious mononucleosis.

Neutropenic enterocolitis (typhlitis) is an unusual acute complication of neutropenia, most often associated with leukaemia and lymphoma and characterized by segmental caecal and ascending colonic ulceration that may progress to necrosis, perforation, and septicaemia. We present a unique case of an 8-year-old girl with recently diagnosed infectious mononucleosis having findings consistent with typhlitis on abdominal CT.

Cecum↗
PubMed1994

An abnormal umbilical artery waveform: a strong and independent predictor of adverse perinatal outcome in patients with preeclampsia.

OBJECTIVE: An abnormal umbilical artery Doppler waveform is a risk factor for adverse perinatal outcome. However, it has not been established whether this is related to the earlier gestational age at delivery of fetuses with abnormal Doppler findings or whether Doppler findings are an independent predictor of perinatal outcome. Our purpose was to determine whether an abnormal Doppler umbilical artery waveform is associated with adverse perinatal outcome even after the gestational age at delivery is controlled for as a confounding variable in patients with preeclampsia. STUDY DESIGN: Umbilical artery velocimetry studies were performed within 7 days of delivery in 72 consecutive patients admitted to our unit with preeclampsia. Adverse perinatal outcome was defined as fetal distress requiring cesarean delivery. Apgar score < 7 at 5 minutes, significant neonatal morbidity, or perinatal death. Significant neonatal morbidity was defined as neonatal sepsis, intraventricular hemorrhage (grade > or = 2), respiratory distress syndrome, pneumonia, bronchopulmonary dysplasia, acute renal failure, or necrotizing enterocolitis. Stepwise multiple logistic regression and receiver-operator characteristic curve analysis were used. RESULTS: Patients with abnormal umbilical artery velocimetry had a significantly higher rate of complications, including cesarean section for fetal distress, preterm delivery, low Apgar scores, significant neonatal morbidity, and perinatal death, than did patients with a normal waveform. Receiver-operator characteristic curve and stepwise logistic regression analysis indicated that an abnormal umbilical artery waveform was a significant independent predictor for the development of adverse perinatal outcome (odds ratio 14.2, p < 0.005) after other confounding variables were adjusted. CONCLUSION: An abnormal Doppler umbilical artery waveform is a strong and independent predictor of adverse perinatal outcome in patients with preeclampsia.

Adult↗
PubMed1990

Experimental primary postnatal bovine viral diarrhea viral infections in six-month-old calves.

Eight clinically healthy calves were inoculated intranasally, four with either noncytopathic or four with cytopathic bovine viral diarrhea virus, and were necropsied 5 or 12 days post-inoculation. The most frequent gross lesion associated with noncytopathic or cytopathic viral infection was proximal colonic mural edema. Consistent microscopic findings were acute to subacute tracheitis, mild enterocolitis with edema, petechial hemorrhages of mesenteric lymph nodes with mild follicular lymphocytic depletion, and paracortical lymphocytic hyperplasia. At necropsy, cytopathic virus was recovered from 4/4 calves and noncytopathic virus was isolated from 2/4 calves. Neutralizing antibodies to noncytopathic bovine viral diarrhea virus were detected in the two calves from which noncytopathic virus was not recovered. Immunohistochemical analysis of lymphoid tissues demonstrated a small, randomly distributed population of mononuclear cells that contained bovine viral diarrhea viral antigen in 7/8 calves.

Animals↗
PubMedDate not supplied

[Phlegmonous colitis].

Phlegmonous inflammation of the digestive tract is a rare lesion related in the majority of the previously described cases to systemic infections and chronic hepatic diseases. Both process may promote gastric and intestinal loss of the mucosal local defenses mechanisms against bacterial invasion. The term phlegmonous enterocolitis or gastritis defines an acute inflammatory process with purulent or nonpurulent character, that selectively damages the gastric, small and large intestines submucosal layer. The intestinal lesions are more frequently located in the small portion, followed by the colonic involvement. In the present paper we describe the postmortem findings and clinical course of a case with phlegmonous colitis in a 53 years old woman with cirrhosis and S pneumoniae septicemia.

Cellulitis↗
PubMed1979

[Acute primary ischemic enteritis and colitis. Clinico-pathological and physio-pathological findings].

By opposition to acute post-operative ischaemic enterocolitis, the authors isolate, with the aid of seven cases, the intestinal lesions which spontaneously occur on the small intestines and on the colon and due to an ischaemic mechanism without thrombosis of the mesenteric vessels. After the description of clinical and anatomical features, they point out the main part of the vascular factor in the genesis of the lesions.

Aged↗
PubMed1997

[From vascular surgery to gastrointestinal surgery].

From the basic and clinical study of the peripheral vascular disturbance, my interest has gradually focused on the visceral circulation, following the first experience of an acute bowel gangrene. Thereafter, I have investigated acute mesenteric ischemia and ischemic enterocolitis both clinically and experimentally. Furthermore, I have also noticed on the combined vascular resection for the malignancies of the gastrointestinal organs. Finally, I have discussed on the role of newly introduced vascular intervention for the gastrointestinal disorders. Further development in many fields will surely lead to great possibility in the future.

Gastroenterology↗
PubMed1998

[Perinatal risk factors for mortality in the high-risk newborn].

This study was to determine the risk factors for mortality in a cohort of neonates in a neonatal intensive care unit. Comparative study of the perinatal antecedents between lives and deaths, calculating risk factors for mortality by the chi square test, with Mantel and Haenzel corrected and bivariate analysis. We studied 425 neonates with, weight and age of gestation 1640 +/- 359 gr. and 32 +/- 2 weeks (X and SD), all required assisted mechanical ventilation during 10 +/- 12 days, and stayed in NICU 13 +/- 12 days. The risk factor for mortality were (p < 0.05); gesta IV, < 1 abortion previously, premature rupture of placenta, premature rupture of membranes with chorioamnionitis, pelvic delivery for vaginal via, age of gestation < 28 weeks, birth weight < 1,000 gr., septic shock, metabolic acidosis, acute renal failure, neonatal necrotizing enterocolitis and air leak. In this group of high risk neonates, for the prenatal, neonatal and postnatal antecedents, we find 12 risk factors for mortality; four attributed to the pregnancy, on to the delivery and seven for problems of the neonate.

Cohort Studies↗
PubMed1987

Rapid diagnosis of neutropenic enterocolitis (typhlitis) by ultrasonography.

Neutropenic enterocolitis (also termed typhlitis) is an acute necrotizing process involving segments of the large and small intestine that occurs in the setting of agranulocytosis, most commonly in patients with acute leukemia. Rapid diagnosis and treatment is necessary for survival. We present a patient in whom abdominal ultrasonography revealed evidence of bowel wall thickening and ascites, confirming the diagnosis of neutropenic enterocolitis. Sonography offers a rapid, safe, and noninvasive means of diagnosis for this condition.

Agranulocytosis↗
PubMed1998

Specific inhibition of plasma kallikrein modulates chronic granulomatous intestinal and systemic inflammation in genetically susceptible rats.

The kallikrein-kinin (K-K) (contact) system is activated during acute and chronic relapsing phases of enterocolitis induced in genetically susceptible Lewis rats by intramural injection of peptidoglycan-polysaccharide (PG-APS). Using the selective plasma kallikrein inhibitor P8720, we investigate whether activation of the K-K system plays a primary role in chronic granulomatous intestinal and systemic inflammation in this model. Group I (negative control) received human serum albumin intramurally. Group II (treatment) received PG-APS intramurally and P8720 orally. Group III (positive control) received PG-APS intramurally and albumin orally. P8720 attenuated the consumption of the contact proteins, high molecular weight kininogen (P<0.03), and factor XI (P<0.04) in group II vs. group III. P8720 decreased chronic intestinal inflammation measured by blinded gross (P<0.01) and histologic (P<0.0005) scores as well as systemic complications (arthritis, splenomegaly, hepatomegaly, leukocytosis, and acute-phase reaction) (P<0.01) in group II as compared with group III. We conclude that relapsing chronic enterocolitis and systemic complications are in part due to plasma K-K system activation, and that inhibition of this pathway is a potential therapeutic approach to human inflammatory bowel disease and associated extraintestinal manifestations.

Acute-Phase Proteins↗
PubMed1988

[Epidemic outbreak of necrotizing enterocolitis coincident with an epidemic of neonatal rotavirus gastroenteritis].

Authors present four cases of neonatal necrotizing enterocolitis occurred during an outbreak of acute enteritis. From november 1985 to beginning of february 1986, forty-seven out of 588 newborn infants were involved. In 22 affected infants (46.8%) rotavirus were isolated from stools, whereas no bacterial or viral agent was recovered in 25 (53.2%). Four cases (8.6%) developed necrotizing enterocolitis.

Birth Weight↗
PubMed1983

[Ulcero-necrotic enterocolitis complicated by peritonitis].

Among 217 patients with acute peritonitis there were 12 patients with the peritonitis developed against the background of segmentary enteritis or colitis. The article describes this form of peritonitis characterized by great severity, rapid development and high death rate. On the detection of a necrotic segment of the small intestine, a one-step resection within the limits of healthy tissues is indicated. Two-steps operations are expedient for necrosis of the colon.

Adolescent↗
PubMed1999

Growth and neurodevelopmental outcome in extremely-low-birth-weight infants after laparotomy.

Twenty-one extremely-low-birth-weight (ELBW) and premature infants (<29 weeks' gestation and/or <1,000 g) underwent emergency laparotomy for acute intra-abdominal pathology (necrotising enterocolitis [NEC] 16, other bowel pathology 5) during the 4-year period from 1990 to 1993; 11 died. The neurodevelopmental outcome of the 10 survivors was assessed and compared with 20 living, otherwise normal controls matched for gestational age, birth weight, and year of birth to asses the effect of the abdominal event on quality of survival. Those who survived after laparotomy had a worse neurodevelopmental outcome than controls (P < 0.05). During this period, we also compared 24 infants in the ELBW category who developed NEC but did not require a laparotomy with the 16 ELBW infants with NEC who required a laparotomy. Those who required a laparotomy had worse disease and had significantly worse neurodevelopmental outcomes (P < 0.01). ELBW and premature infants who have acute intra-abdominal pathology requiring a laparotomy are thus at increased risk of neurodevelopmental problems and poor growth. Close long-term follow-up is important, and the families of such infants should be made aware before surgery of the increased risk the abdominal event has on their babies' developmental outcome if they survive.

Developmental Disabilities↗
PubMed2002

Successful management in the case of mesenteric ischemia complicated with acute type a dissection.

We report a case of acute type A dissection with ischemic enterocolitis due to blood flow insufficiency in the superior mesenteric artery. A 67 year-old man, with medicated ischemic heart disease and hypertension, presented to another hospital with chest pain radiating to the back and epigastrium. Contrast-enhanced computed tomography revealed a type A dissecting aneurysm, that extended from the ascending aorta to the left common iliac artery, with a 50-mm diameter in the ascending aorta. Celiac trunk and left renal artery arose from the false lumen, and the superior mesenteric artery (SMA) was compressed by the thrombosed false lumen. Symptoms of acute mesenteric ischemia clearly developed. Then, a large amount of tarry stool (melena) was discharged. First, an emergency saphenous vein bypass was performed from the common iliac artery to the superior mesenteric artery at the orifice of the ileocolic artery where it was free from dissection. Then total arch replacement was performed using cardiopulmonary bypass. The patient's postoperative course was uneventful, and the abdominal symptoms completely disappeared. This case demonstrates that prompt surgical relief of ischemia in major organs is important to save lives in the cases of acute aortic dissection with ischemic complications.

Aged↗