Abstract:
:Diverticulitis represents a spectrum of clinical entities ranging from minimal pericolitis in the adjacent mesentery to uncontrolled intra-abdominal sepsis and septic shock. The presentation most often described is left lower quadrant abdominal pain, fever, chills, and left lower quadrant tenderness associated with a mass. Unusual presentations occur when infection tracts to distant locations. Diverticulitis is a common cause of intra-abdominal sepsis associated with high morbidity and mortality. The pathogenesis of intra-abdominal sepsis is not well understood, but likely involves circulating host inflammatory mediators. The role of computed tomography in the early diagnosis of diverticulitis is increasing and supersedes barium enema in the assessment of the extracolonic extent of disease. Also, computed tomographic-directed percutaneous drainage of intra-abdominal abscesses is, in most cases, as effective as surgical drainage. Predictably, the micro-organisms involved are representatives from the commensal flora of the lower gastrointestinal tract. These bacteria are usually sensitive to a wide range of antimicrobial agents that are effective against facultative and obligate anaerobic gram-negative bacilli. Surgical intervention is reserved for those individuals who do not respond to therapy, or for generalized peritonitis, uncontrolled sepsis, free viscus perforation, and fistulas.
journal_name
Gastroenterol Clin North Amjournal_title
Gastroenterology clinics of North Americaauthors
Pohlman Tsubject
Has Abstractpub_date
1988-06-01 00:00:00pages
357-85issue
2eissn
0889-8553issn
1558-1942journal_volume
17pub_type
杂志文章,评审abstract::Studies of ontogenesis contribute to better understanding of regulatory events underlying the striking heterogeneity in B-cell differentiation pathways employed in the human mucosal immune system. This disparity is probably explained by exogenous environmental factors, although regional differences probably also exist...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1991-09-01 00:00:00
abstract::Swallowed fluticasone and oral viscous budesonide are effective first-line therapies for eosinophilic esophagitis in children. Side effects are minimal without evidence of Cushing syndrome, as seen in treatment with systemic corticosteroids. New studies on alternative delivery systems and different corticosteroids (eg...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章
doi:10.1016/j.gtc.2014.02.008
更新日期:2014-06-01 00:00:00
abstract::Chronic intestinal pseudo-obstruction (CIPO) is a severe form of intestinal dysmotility disorder, characterized by the impairment of gastrointestinal propulsion of the gut content in the absence of fixed occluding lesions. CIPO is a rare disease that can develop in both children and adults. CIPO is classified as prima...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2019.08.005
更新日期:2019-12-01 00:00:00
abstract::A persisting reservoir of the Gulf Coast strain of toxigenic V. cholerae O1 in Louisiana and Texas marshes and the shipment of seafood from these areas throughout the United States means that sporadic cases and outbreaks of cholera may occur anywhere in the country for the foreseeable future. Such cases are most likel...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1993-09-01 00:00:00
abstract::Hepatic angiosarcoma is the second most common primary malignant neoplasm of the liver. Although comprising only 2 per cent of all hepatic primary tumors, it represents a major clinical problem because of its strong association with industrial vinyl chloride exposure and its incurability. Strict ceilings on the amount...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1987-12-01 00:00:00
abstract::Pediatric pancreatitis is an emerging field with an increasing incidence of disease. Management of pediatric pancreatitis is understudied and, therefore, extrapolated from adult studies (although the etiologies are different). There is evidence that feeding is safe in mild acute pancreatitis in children without increa...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2018.07.003
更新日期:2018-12-01 00:00:00
abstract::This article defines obesity, ideal body weight, morbid obesity, and indexes of overweight, pointing out some of the difficulties in studies of the epidemiology of morbid obesity. ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章
doi:
更新日期:1987-06-01 00:00:00
abstract::The role of hormones and growth factors in the pathogenesis and therapy of colon cancer is biologically intricate and medically important. The effects of the previously described hormones and growth factors on normal and neoplastic colonic growth and development suggest the mechanisms by which hormonal alteration migh...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1988-12-01 00:00:00
abstract::Because there are no reliable biological or laboratory markers associated with the condition, the diagnosis of irritable bowel syndrome(IBS) is based on patient descriptions of common symptoms such as abdominal pain accompanied by changes in stool form or frequency and associated symptoms such as bloating and distensi...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2005.03.001
更新日期:2005-06-01 00:00:00
abstract::The goal of nutritional support in acute pancreatitis is to reduce inflammation, prevent nutritional depletion, correct a negative nitrogen balance, and improve outcomes. Enteral nutrition (EN) in severe acute pancreatitis (SAP) should be preferred to parenteral nutrition. It maintains the integrity of the gut barrier...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2017.10.002
更新日期:2018-03-01 00:00:00
abstract::Nutritional support can improve the outcome from severe acute pancreatitis in two ways: first by providing the building blocks for tissue repair and recovery, and second, by modulating the inflammatory response and preventing organ failure, both of which are responsible for most of the morbidity and mortality associat...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2007.03.009
更新日期:2007-06-01 00:00:00
abstract::Ulcerative colitis and Crohn disease are chronic inflammatory diseases with typical onset in early adulthood. These diseases, therefore, can affect a woman throughout the many stages of her life, including menstruation, sexuality, pregnancy, and menopause. Unique health issues face women during these stages and can af...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2016.02.007
更新日期:2016-06-01 00:00:00
abstract::Chronic HIV-associated diarrhea is currently a field in flux. Improved noninvasive diagnostic tests, improved pathogen-specific regimens, and better empiric therapies may change some of the assumptions used to select algorithms for diagnostic evaluation and management. Any shift in the cause of diarrhea from pathogen-...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(05)70203-x
更新日期:2001-09-01 00:00:00
abstract::The role of the aminosalicylates for induction therapy of mild moderate ulcerative colitis and as maintenance treatment has been substantiated by a large series of controlled clinical trials and confirmatory meta-analyses. Both sulfasalazine and newer derivatives are effective in preventing relapses. It remains to be ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2004.02.010
更新日期:2004-06-01 00:00:00
abstract::CD and UC represent a spectrum of chronic IBD that present in protean ways and are accompanied by a variety of systemic sequelae. Sulfasalazine and the newer 5-aminosalicylates are important in the management of mild-to-moderate disease, whereas corticosteroids remain the primary therapy for most patients with moderat...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(05)70058-3
更新日期:1999-06-01 00:00:00
abstract::The presence of stigmata of hemorrhage in a peptic ulcer indicate an increased risk of rebleeding and the need for endoscopic intervention. Clinical trials indicate that laser photocoagulation, multipolar and heater probe coagulation, and injection therapy are all effective in decreasing bleeding from peptic ulcer dis...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1993-12-01 00:00:00
abstract::The intestine contains major subdivisions of the nervous and immune systems. The lymphoid compartments of the intestine contain functionally distinguishable populations of immunologic cells and are innervated differently. The lamina propria has an extensive network of nerves using the neuropeptides SOM, SP, and VIP. S...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1991-09-01 00:00:00
abstract::Colorectal cancer is a major illness in the Western world. International and migrant studies suggest that environmental causes, notably a fat- and calorie-dense diet (even if adopted in adulthood), are associated with the disease. Case-control studies have not conclusively identified specific etiologic dietary factors...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1988-12-01 00:00:00
abstract::Upper gastrointestinal bleeding (UGIB) is the most common emergency condition in gastroenterology. Although peptic ulcer and esophagogastric varices are the predominant causes, other conditions account for up to 50% of UGIBs. These conditions, among others, include angiodysplasia, Dieulafoy and Mallory-Weiss lesions, ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2014.08.004
更新日期:2014-12-01 00:00:00
abstract::Current practice guidelines recommend annual fecal occult blood test screening for colorectal cancer in the average-risk population over the age of 50. Efficacy of fecal occult blood test screening is supported by several controlled prospective trials and case-control studies. Implementation of this recommendation, in...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(05)70283-1
更新日期:1997-03-01 00:00:00
abstract::Anal cancer is rare and this helps to explain why anal pre-neoplastic conditions are poorly understood, especially with regard to their natural history and management. Anal intraepithelial neoplasia is closely linked to human papillomavirus infection and is particularly common in homosexuals and in immunosuppressed pa...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2007.08.001
更新日期:2007-12-01 00:00:00
abstract::Gastroparesis is a heterogeneous disorder defined by delay in gastric emptying. Symptoms of gastroparesis are nonspecific, including nausea, vomiting, early satiety, bloating, and/or abdominal pain. Normal gastric motor function and sensory function depend on a complex coordination between the enteric and central nerv...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2014.11.003
更新日期:2015-03-01 00:00:00
abstract::Irritable bowel syndrome (IBS) is a common disorder that has been shown to aggregate in families and to affect multiple generations, but not in a manner consistent with a major Mendelian effect. Relatives of an individual with IBS are 2 to 3 times as likely to have IBS, with both genders being affected. To date, more ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2010.12.011
更新日期:2011-03-01 00:00:00
abstract::Focal liver lesions occur commonly and with varying histology, each requiring radically different management. There are a multitude of imaging modalities currently being used for detecting and characterizing focal liver neoplasms. The primary modalities include ultrasonography, computed tomography (CT), magnetic reson...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(02)00028-6
更新日期:2002-09-01 00:00:00
abstract::Probiotics have been studied in a variety of GI infections, and are an appealing concept given their favorable safety profiles. Several placebo-controlled trials indicated that lactobacilli have a suppressive effect on H pylori infection. Although some studies reported improvement in H pylori eradication, others faile...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2006.03.005
更新日期:2006-06-01 00:00:00
abstract::The evaluation and treatment of patients after operations on the foregut is a challenge for physicians and surgeons. The early postoperative period is an especially important interval because the very survival of the patient as well as the success of the surgical intervention depends on the correct interpretation of t...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1994-06-01 00:00:00
abstract::Hepatocellular carcinomas can be further divided into distinct subtypes that provide important clinical information and biological insights. These subtypes are distinct from growth patterns and are on based on morphologic and molecular findings. There are 12 reasonably well-defined subtypes as well as 6 provisional su...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2017.01.009
更新日期:2017-06-01 00:00:00
abstract::Surveillance for hepatocellular carcinoma (HCC) has become routine despite a lack of evidence of efficacy. Suitable candidates for surveillance include patients with cirrhosis and some subsets of noncirrhotic chronic hepatitis B carriers. The best surveillance testis ultrasonography at 6- to 12-month intervals. Serolo...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2004.04.012
更新日期:2004-09-01 00:00:00
abstract::Being the final pathway for chyme and digestive residues, the colorectum influences bowel function critically. The most important and relevant symptoms of colonic dysfunction are diarrhea, constipation, urgency, and pain. Despite the effects of many investigators, over several decades, the motor physiology of the huma...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(05)70369-1
更新日期:1996-03-01 00:00:00
abstract::This article highlights the different dietary approaches that have evolved and become popular over the past few years. Whether these are fads or truly represent important changes in the way peo-ple eat and that ultimately will lead to a lower rate of obesity and improved health is impossible to know. ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2004.12.007
更新日期:2005-03-01 00:00:00