Roentgen Criteria of Impending Perforation of the Cecum

Davis, Lawrence A.; Lowman, Robert M.

doi:10.1148/68.4.542

Cited by 29 publications

(17 citation statements)

References 5 publications

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“…This finding should nonetheless be considered indicative of a long-standing stenosis, and it is due to excessive bacterial proliferation with progressive distension of the intestinal lumen [27][28][29].…”

Section: Discussionmentioning

confidence: 99%

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Prognostic value of MDCT in malignant large-bowel obstructions

Angelelli¹,

Moschetta²,

Binetti³

et al. 2010

Radiol med

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Section: Discussionmentioning

confidence: 99%

“…Il riscontro di tale alterazione deve, comunque, essere considerato significativo di una stenosi protratta nel tempo ed è riferibile ad una eccessiva proliferazione batterica, responsabile di una progressiva distensione del lume intestinale [27][28][29].…”

Section: Discussionunclassified

Prognostic value of MDCT in malignant large-bowel obstructions

Angelelli¹,

Moschetta²,

Binetti³

et al. 2010

Radiol med

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“…Surgical intervention is indicated if the diagnosis is in doubt or if spontaneous rupture of the caecum is suspected. This complication has occurred in pseudo-obstruction (Melamed and Kubian, 1963) and should be anticipated when right iliac fossa tenderness appears or abdominal X-ray shows a caecal diameter of more than 9 cm (Lowman and Davis, 1956).…”

Section: Treatmentmentioning

confidence: 96%

Pseudo-obstruction of the large bowel

1974

British Journal of Surgery

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SUMMARYTweloe episodes of large bowel pseudo-obstruction occurring in I 1 patients are described. The clinical and radiological features are discussed from a diagnostic aspect. The aetiology and treatment of the condition are considered.PSEUDO-OBSTRUCTION denotes apparent intestinal obstruction occurring in the absence of occlusion of the alimentary lumen. It may occur spontaneously, but frequently it is associated with pathology elsewhere in the body. The aetiology is uncertain and the condition presents problems in both diagnosis and management. This paper reports the author's personal experiences with 1 1 patients who presented with the large bowel syndrome in a period of 3+ years. Case reportsCase 1 : An 86-year-old man was admitted as an emergency on 23 February 1969. He lived alone and had been found collapsed and covered with vomit. He was dehydrated, confused and partially blind and had mild Parkinsonism. The abdomen was distended but not tender. Occasional bowel sounds were heard and the rectum was empty.His haemoglobin was 14.2 g/lOO ml. Abdominal X-rays showed many dilated loops of small bowel and a few fluid levels.An enema produced a moderate result. Laparotomy revealed gross distension of the small bowel and of the large bowel as far as the splenic flexure. Beyond this, the colon was collapsed and no mechanical cause for the apparent obstruction could be found. The small bowel was decompressed.Postoperatively the abdominal distension persisted for several weeks. The patient remained very lethargic and died from bronchopneumonia 3 months later. CUSP 2: A 78-year-old bronchitic and hemiplegic man was admitted as an emergency on 22 June 1969 with chronic retention of urine. His bowel habit had always been regular.Investigations showed a blood urea of 68 mg/100 ml and a WBC of 12 O O O /~I~.~ The haemoglobin and electrolytes were within normal limits.Catheter drainage of the bladder was unsatisfactory and the blood urea rose to 196 mg/100 ml 6 days after admission. Gross abdominal distension with generalized tenderness and guarding then developed. Abdominal X-rays showed multiple fluid levels and gross distension of the transverse colon (Fig. I), while gas was absent from the sigmoid colon. Sigmoidoscopic decompression with a flatus tube proved ineffectual. At laparotomy there was moderate distension of the caecum and ascending and transverse colon. The descending colon was collapsed and what was thought to be a carcinoma of the splenic flexure was felt. Caecostomy was performed.At a further laparotomy 23 weeks later the previously felt mass proved to be merely adhesions between the omentum and spleen. No cause for the apparent obstruction was found. The caecostomy closed spontaneously and the patient later had an uneventful prostatectomy. Case 3 : A 60-year-old man was admitted as an emergency on 16 July 1969 with a 24-hour history of severe central abdominal pain and constipation but no vomiting. The abdomen was a little distended. with generalized tenderness, guarding, rebound tenderness and absent ...

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“…A colonic diameter of 9 cm is commonly used as the value associated with high risk of perforation. 15 However, in a review of 400 cases, Vanek and Al-salti 4 did not see colonic perforation when the colonic diameter was less than 12 cm. 4 Some studies have suggested that the duration of colonic dilatation may be a more important risk factor for perforation than the actual colonic diameter.…”

Section: Discussionmentioning

confidence: 95%

Pseudomembranous colitis without diarrhea presenting clinically as acute intestinal pseudo-obstruction

Sheikh

Pauly

Trudeau

2001

Journal of Gastroenterology

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Pseudomembranous colitis usually presents with diarrhea in a clinical setting of recent antibiotic use. It is uncommon to see it as a cause of obstipation and colonic pseudo-obstruction. We report an unusual case of an elderly woman with hypertension, congestive heart failure, chronic obstructive pulmonary disease, chronic renal insufficiency, and diabetes mellitus, who was admitted with fever, abdominal pain, and distension without diarrhea. She presented with decreased stool frequency and obstipation. She did not respond to conservative management. Colonoscopy revealed a picture of pseudomembranous colitis, and Clostridium difficile toxin was positive. She responded well to metronidazole therapy.

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Roentgen Criteria of Impending Perforation of the Cecum

Cited by 29 publications

References 5 publications

Prognostic value of MDCT in malignant large-bowel obstructions

Prognostic value of MDCT in malignant large-bowel obstructions

Pseudo-obstruction of the large bowel

Pseudomembranous colitis without diarrhea presenting clinically as acute intestinal pseudo-obstruction

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