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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Primary indications and metabolic consequences for use of bowel segments[1-17]

Primary indications and metabolic consequences for use of bowel segments[1-17]
Bowel segment Primary indication Metabolic consequences Clinical symptoms
Gastric

Children requiring diversion (exstrophy, pelvic radiation)

Renal insufficiency

 Metabolic alkalosis (↓ K, ↓ Cl, hypergastrinemia)

Hematuria-dysuria syndrome

Volume depletion, lethargy, seizures, respiratory distress
Jejunum

Pelvic radiation

Deficient ureteral length

Compromised viability of other small or large bowel

 Hyperchloremic metabolic acidosis, hyperkalemia, azotemia Volume depletion, nausea/vomiting, weakness, lethargy, seizures
Ileum or ileal-colic reservoirs

Malignancies requiring removal of the bladder

Severe hemorrhagic cystitis

Incontinence

 Hyperchloremic metabolic acidosis, hyperkalemia, azotemia

Fatigue, anorexia, weight loss, diarrhea, polydipsia

B12 and fat-soluble vitamin deficiency

Diarrhea, urinary calculi, cholelithiasis
Colon (ureterosigmoidostomy)

Children requiring diversion (exstrophy, pelvic radiation)

No other bowel segment alternative

 Hyperchloremic metabolic acidosis, hyperkalemia, azotemia

Fatigue, anorexia, weight loss, diarrhea, polydipsia

Pyelonephritis

Adenocarcinoma at anastomotic site
Transverse colon conduit

Malignancies requiring removal of the bladder

Small bowel not practical

 Metabolic acidosis (↑ Cl, ↓ bicarbonate, azotemia)

Fatigue, anorexia, weight loss, diarrhea, polydipsia

Pyelonephritis

Adenocarcinoma at anastomotic site
K: potassium; Cl: chloride; ↓: decreased; ↑: increased.
References:
  1. Adams, MC, Mitchell, ME, Rink, RC. Gastrocystoplasty: an alternative solution to the problem of urological reconstruction in the severely compromised patient. J Urol 1988; 140:1152.
  2. Kaveggia, FF, Thompson, JS, Schafer, EC, et al. Hyperammonemic encephalopathy in urinary diversion with urea-splitting urinary tract infection. Arch Intern Med 1990; 150:2389.
  3. McDougal, WS, Koch, MO. Accurate determination of renal function in patients with intestinal urinary diversions. J Urol 1986; 135:1175.
  4. Koch, MO, McDougal, WS, Flora, MD. Urease and the acidosis of urinary intestinal diversion. J Urol 1991; 146:458.
  5. Koch, MO, McDougal, WS, Thompson, CO. Mechanisms of solute transport following urinary diversion through intestinal segments: an experimental study with rats. J Urol 1991; 146:1390.
  6. Klein, EA, Montie, JE, Montague, DK, et al. Jejunal conduit urinary diversion. J Urol 1986; 135:244.
  7. Plawker, MW, Rabinowitz, SS, Etwaru, DJ, Glassberg, KI. Hypergastrinemia, dysuria-hematuria and metabolic alkalosis: complications associated with gastrocystoplasty. J Urol 1995; 154:546.
  8. Nguyen, DH, Bain, MA, Salmonson, KL, et al. The syndrome of dysuria and hematuria in pediatric urinary reconstruction with stomach. J Urol 1993; 150:707.
  9. Gosalbez, R Jr, Woodard, JR, Broecker, BH, Warshaw, B. Metabolic complications of the use of stomach for urinary reconstruction. J Urol 1993; 150:710.
  10. Filipsson, S, Hulten, L, Lindstedt, G. Malabsorption of fat and vitamin B12 before and after intestinal resection for Crohn's disease. Scand J Gastroenterol 1978; 13:529.
  11. Thompson, WG, Wrathell, E. The relation between ileal resection and vitamin B12 absorption. Can J Surg 1977; 20:461.
  12. Koch, MO, McDougal, WS. Chlorpromazine: adjuvant therapy for the metabolic derangements created by urinary diversion through intestinal segments. J Urol 1985; 134:165.
  13. Boyd, SD, Schiff, WM, Skinner, DG, et al. Prospective study of metabolic abnormalities in patient with continent Kock pouch urinary diversion. Urology 1989; 33:85.
  14. Koch, MO, Gurevitch, E, Hill, DE, McDougal, WS. Urinary solute transport by intestinal segments: a comparative study of ileum and colon in rats. J Urol 1990; 143:1275.
  15. Mills, R. D., Studer, U. E.: Metabolic consequences of continent urinary diversion. J Urol 1999; 161:1057.
  16. Stampfer, DS, McDougal, WS, McGovern, FJ. The use of in bowel urology. Metabolic and nutritional complications. Urol Clin North Am 1997; 24:715.
  17. McDougal, WS, Stampfer, DS, Kirley, S, et al. Intestinal ammonium transport by ammonium and hydrogen exchange. J Am Coll Surg 1995; 181:241.
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