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[Influence of alpha and beta blocking agents on recovery of intestinal transit and postoperative complications in aged patients].

Following the recovery of intestinal peristaltic movements in medium and advanced age patients in whom major surgery had been performed, after an adequate preparation with and blocking agents, as compared with the control group, a shortening was noted, of the intestinal paresis period in both age groups. The early recovery of intestinal transit had positive effects on the postoperative evolution of the patients, especially in the aged ones, and allowed for an early resumption of oral alimentation, reducing abdominal meteorization, as well as the number and the severity of local and general complications.

Adrenergic alpha-Antagonists↗

[Anesthesia for primary excision and grafting in the severely burned patient (author's transl)].

Through a retrospective study of 81 anaesthesias for primary excision with immediate grafting (performed within the first 72 hours after burning), the authors, using in most of the cases an anaesthetic procedure including neuroleptanalgesia and nitrous oxyde, with controlled ventilation, tried to determine: --the incidence of such a type of anaesthesia on the patient condition, --the period during which anaesthetic risk is the least. Studies of hemodynamic, respiratory and thermic changes, related with anaesthesia, and a study of coagulation changes, related with surgical procedure, have been performed. It appears that neuroleptanalgesia is a method available for primary excision with immediate grafting and that the elective period for anaesthesia and surgical procedure is situated within 12 hours after burning.

Adolescent↗

[Paralytic ileus].

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Diagnosis, Differential↗

[Complications of lumbar sympathectomy. Retrospective study of 791 patients].

The purpose of this paper is to define the nature and the frequency of post-lumbar sympathectomy complications and to reappreciate their importance in the evaluation of operative indication. The non specific miscellaneous complications are no more frequent than after any other lombotomy. The specific complications occur in less than 10%; they are almost always transient. Prolonged paralytic ileus is related to post-operative hematoma in retroperitoneal space. Ejaculation disturbances are produced either by bilateral resection of one of the two first lumbar ganglian or by section of the intermesenteric plexus, the presacral nerves or the hypogastric nerves during associated dissection of the aortic bifurcaiton. Late neuralgia is probably induced by retroperitoneal hematoma; its size increases gradually during the postoperative period by transference of tissue fluids. In conclusion, the morbidity and the morbidity rates of lumbar sympathectomy are remarkably low; these are not arguments against the lumbar sympathectomy.

Adult↗

[Gunshot injuries of chest and abdomen (author's transl)].

A total of 51 patients with gunshot injuries of the chest and the abdominal cavity were treated at the Emergency Aid Institute "Pirogov" in Sofia from 1967 to 1976. The series included 45 men and 6 women, with a letality rate amounting to 21.5 per cent (11 patients). In 41 per cent it was a matter of abdominal injury where the letality was the highest (33 per cent). Chest injuries included 33 per cent with 12 per cent letality, while combined chest-abdominal injuries included 26 per cent with 14 per cent letality. Involvement of the small and large intestine showed the highest incidence of all abdominal organs (37 per cent). Traumatic-hemorrhagic shock and acute respiraotyr insufficiency prevailed. The operative tacties resorted to was strictly individual. In combined lesions of treatment of respiratory insufficiency, parenchymatous organs and major blood vessels has priority over the treatment of hollow organs.

Abdominal Injuries↗

Chronic pseudo-obstruction secondary to side-to-side intestinal anastomosis.

An unusual late complication of side-to-side intestinal anastomosis, chronic small-bowel obstruction with massive proximal ileal dilation despite a widely patent anastomosis, occurred in a patient. The classic blind loop syndrome was not present. Several potential mechanisms are suggested, including regional absence of normal peristalsis on a mechanical basis and bacterial overgrowth. This report adds support to the concept that side-to-side intestinal anastomosis should be avoided whenever possible.

Blind Loop Syndrome↗

Role of intestinal microflora in colonic pseudoobstruction complicating jejunoileal bypass.

A double-blind crossover study using placebo and antibiotics effective against either aerobic or anaerobic organisms has been performed to elucidate the role of intestinal microflora in the pathogenesis of colonic pseudo-obstruction, which is now established as an important complication of jejunoileal bypass. Using strict Virginia Polytechnic Institute (VPI) technique, quantitative bacterial studies of the intestinal flora in the region of bypassed bowel have been correlated with symptoms of abdominal pain and distension. It has been shown that antibiotics effective against obligate anaerobes rapidly relieve the symptoms of pseudo-obstruction and this coincides with the disappearance of these organisms from this region of bowel. Symptoms rapidly recur when anaerobic organisms repopulate the bowel. It is concluded that obligate anaerobes may play a role in the pathogenesis of this complication.

Bacteria↗

Pseudo-obstruction of the bowel in pregnancy: case reports.

Two patients with intestinal obstruction in pregnancy are presented and discussed. In neither case was there any obvious cause for the intestianl obstruction. Pseudo-obstruction of the bowel has not previously been described as a complication of pregnancy.

Adult↗