Disease relevance of Intestinal Obstruction

• Compound inactivation of Smad2 in heterozygous Apc mutant mice did not change the total number of intestinal tumors but increased sudden death from intestinal obstruction caused by extremely large tumors [1].
• Fecal impaction following methadone ingestion simulating acute intestinal obstruction, [2].
• BACKGROUND AND AIMS: The endothelin ETB receptor null rat (ETB(-/-)R) has an intestinal segment without ganglia, and this rat is characterised by intestinal obstruction similar to that observed in human Hirschsprung's disease [3].
• Hirschsprung's disease (aganglionic megacolon, HSCR) is a frequent condition of unknown origin (1/5000 live births) resulting in intestinal obstruction in neonates and severe constipation in infants and adults [4].
• Wild-type mice fed the liquid diet used to prevent intestinal obstruction in Cftr-knockout mice had inflammatory responses to P. aeruginosa-laden agarose beads similar to those of wild-type mice fed an enriched solid diet, so dietary effects are unlikely to account for differences between wild-type mice and mice with cystic fibrosis [5].

High impact information on Intestinal Obstruction

• Mice that have been made deficient for the cystic fibrosis transmembrane conductance regulator (Cftr) usually die of intestinal obstruction [6].
• This new test has revealed subclinical gut mucosal inflammation in a minority of CF children, for which distal intestinal obstruction syndrome, Nutrizym 22 treatment, or both, may be risk factors [7].
• These results indicate that the patient's acute secretory diarrhea, occurring after large intestinal obstruction, originated in the small intestine and that SMS 201-995 can be used to manage this unusual severe postoperative problem [8].
• Intestinal obstruction in babies exposed in utero to methylene blue [9].
• Gdnf haploinsufficiency causes Hirschsprung-like intestinal obstruction and early-onset lethality in mice [10].

Chemical compound and disease context of Intestinal Obstruction

• Four successive daily intraperitoneal injections of tubercidin at 5 mg/kg per day produced 100% mortality in mice within 3 to 5 days following the first injection, with massive peritonitis and intestinal obstruction secondary to abdominal adhesions [11].
• METHODS: One hundred and sixty-one patients who suffered from adhesive intestinal obstruction without clinical evidence of strangulation or gangrene underwent a Urografin study [12].
• One girl had low folate and elevated homocysteine levels, and there was one case of intestinal obstruction caused by adhesions [13].
• Effects of cisapride in patients with cystic fibrosis and distal intestinal obstruction syndrome [14].
• This caused the authors to review critically the use of Gastrografin in the differential diagnosis of paralytic ileus versus mechanical intestinal obstruction [15].

Biological context of Intestinal Obstruction

• Signs of intestinal obstruction developed in a 2-month-old infant with trisomy 21 during atropine therapy [16].
• It is proposed that the triad of intestinal obstruction as suggested by vomiting and visible peristalsis, left-sided liver in the presence of laevocardia, and radiographic appearance of reversed double bubble, be considered as indicating MOMS [17].
• Effects of octreotide and a-tocopherol on bacterial translocation in experimental intestinal obstruction: a microbiological, light and electronmicroscopical study [18].
• However early signs of intestinal obstruction and low concentrations of serum cholesterol may indicate cystic fibrosis, regardless of liver histology [19].
• A region on chromosome 19 that modifies intestinal obstruction in CF has been identified based on a region of synteny in the mouse; however, the specific gene has not been completely characterized [20].

Anatomical context of Intestinal Obstruction

• STUDY DESIGN AND SETTING: A set of 3,851 patients registered with the UK CF Database (diagnosed 1986-2003) were divided into four mutually exclusive categories by mode of presentation: meconium ileus or distal intestinal obstruction syndrome (MI/DIOS); positive family history; newborn screening; and symptoms excluding MI/DIOS [21].
• Spurious elevation of amniotic fluid bilirubin in acute hydramnios with fetal intestinal obstruction [22].
• The CF gastrointestinal content itself differs mainly from the normal condition by the lower acidity in the foregut and the accretion of mucins and proteins, eventually resulting in intestinal obstruction, in the ileum and colon [23].
• RESULTS: CRP levels and rates of bacterial translocation, expressed as colony forming units (cfu) per gram wet tissue, were higher in both intestinal obstruction groups than in the native and sham-operated control groups (P < 0.001 for both) [24].

Gene context of Intestinal Obstruction

• The authors describe a clinical case study of gastrointestinal manifestations in a pedigree with MELAS, in which all three children, ages 11, 8, and 6, demonstrated acute onset of intestinal obstruction [25].
• Dysfunction of the CFTR protein results in salty sweat, pancreatic insufficiency, intestinal obstruction, male infertility, and severe pulmonary disease [26].
• Acute intestinal obstruction and NOD2/CARD15 mutations among Italian Crohn's disease patients [27].
• The highest severity scores were associated with impaired activity, sedation, coma, intestinal obstruction, dysphagia and urinary symptoms [28].
• In ten patients with symptoms of recurrent distal intestinal obstruction syndrome prior to institution of therapy, duration of hospitalization was significantly reduced by this treatment (5.1 +/- 7.6 v 2.3 +/- 6.3 hospital days per annum, P less than .02).(ABSTRACT TRUNCATED AT 250 WORDS)[29]

Analytical, diagnostic and therapeutic context of Intestinal Obstruction

• A potential animal model of CF, the CFTR-/- mouse, has had limited utility because most mice die from intestinal obstruction during the first month of life [30].
• They had an exploratory laparotomy to rule out mechanical intestinal obstruction, and required long-term parenteral nutrition to obtain sufficient nutrients [31].
• MATERIALS AND METHODS: Rats were on three feeding regimens-standard diet and water (control group), diet and water containing 2% glutamine (glutamine group), or diet and water containing 2% arginine (arginine group)-for 3 days prior to surgical preparation of intestinal obstruction [32].
• Oral piperazine and racine oil can successfully resolve most subacute cases; however, aggressive resuscitation and prompt surgical intervention in patients with intestinal obstruction result in a satisfactory outcome [33].
• CONCLUSIONS: (1) The incidence of intestinal obstruction is high after lung transplantation in children with CF [34].

References