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Fulltext Fleet enema: a straight up method of management in tar burn injuries

Farrah-Hani, I., Mohamed Sam-Aan, H., K., Enda, Srijit D.

Medicine & Health, 2020;15(2):321-326.
MyJurnal

Lecuran tar, walaupun dikelaskan sebagai kecederaan kimia, disebabkan oleh perbezaan mekanisma kecederaan dan kesukaran untuk mengeluarkan agen daripada kulit tanpa menyebabkan kerosakan kulit dengan lebih lanjutnya, merupakan satu masalah yang sukar untuk diselesaikan. Terutamanya, apabila pesakit pediatrik terlibat. Lecuran tar biasanya merupakan kecederaan pekerjaan dan kebanyakannya berlaku kepada lelaki dewasa. Dua kes dibentangkan di sini, seorang budak lelaki berusia enam tahun dan seorang gadis berusia 15 tahun yang mengalami luka lecuhan tar dan berjaya dirawat dengan menggunakan enema minyak mineral Fleet® dan paraffin tulle Bactigras®, yang mudah didapati di kebanyakan hospital.

Matched MeSH terms: Enema
Comparison of Barium Enema and frozen section results in the diagnosis of Hirschsprung's Disease in a tertiary care hospital at Aceh, Indonesia

Rizky M, Isa MM, Kamarlis RK

Med J Malaysia, 2020 05;75(Suppl 1):37-40.
PMID: 32471967

INTRODUCTION: Hirschsprung's Disease (HD) also called congenital aganglionic megacolon is a disorder caused by undeveloped distal to proximal intestinal nerve ganglion cells. Diagnosis includes determining the aganglionic segment through barium enema radiology examination and histopathology of frozen section with permanent section as gold standard. Determining the diagnostic value of this modality is important for operative management decision.
MATERIALS AND METHODS: The study was a retrospective, cross-sectional study with diagnostic test design. Patient data were obtained in the form of clinical symptoms, barium enema, and frozen section expertise were assessed for the suitability of the diagnostic value by referring to the permanent section as the gold standard.
RESULT: Thirty-four patient data were obtained. The sensitivity, specificity, and accuracy of barium enemas were 95%, 69.2%, and 82%, respectively. The values of sensitivity, specificity, and accuracy of frozen section were 95%, 92.8%, and 88%, respectively. The Cohen-Kappa statistic value was 0.62 (good agreement).
CONCLUSION: Accuracy of FS is better than barium enema in diagnosing HD. In health care center with limitation of histopathological facility, BE could be used as the alternative procedure as interrater comparisons showed good agreement. Therefore, either frozen section or barium enema can be carried out in common or in separate term.

Matched MeSH terms: Barium Enema*
Double contrast barium investigation

Med J Malaysia, 1976 Mar;30(3):225-8.
PMID: 958054
Matched MeSH terms: Enema
Fulltext Barium enema reduction of intussusception in children

Goon Hong Kooi

Med J Malaysia, 1986 Jun;41(2):166-9.
PMID: 3821614

Barium enema hydrostatic reduction was carried out for eight patients with Intussusception over a six-month period. There were five successes (62%) and three failures. There were no mortality or complications arising out of this procedure. The technique is discussed. This procedure offers many advantages over surgical reduction. However, it is not a substitute for surgery which is still indicated in the sick infants and in those where hydrostatic reduction failed.

Matched MeSH terms: Enema*
Fulltext Barium peritonitis--following barium enema of the proximal colon through a colostomy

Liew NC, Gee T, Sandra K, Gul YA

Med J Malaysia, 2003 Dec;58(5):766-8.
PMID: 15190666

Perforation with extravasation of barium is a rare complication of contrast enema examination of the large bowel with a high associated mortality rate. The experience of performing a re-laparotomy in a patient previously exposed to barium peritonitis is even less common. We describe an elderly male patient with a Hartmann's procedure performed a year previously, presenting with peritonitis following barium enema evaluation of the proximal colon via an end descending colon stoma. Emergency laparotomy, segmental bowel resection and liberal peritoneal toilet resulted in a satisfactory outcome. The patient had a subsequent successful reversal of his Hartmann's procedure nine months later despite the presence of dense barium induced adhesions. This potentially preventable iatrogenic complication is discussed in this report, which is supplemented by a brief review of the English literature.

Matched MeSH terms: Enema/adverse effects*
Factors associated with ultrasound-guided water enema reduction for pediatric intussusception in resource-limited setting: potential predictive role of thrombocytosis and anemia

Lim RZM, Lee T, Ng JYZ, Quek KF, Abdul Wahab N, Amansah SL, et al.

J Pediatr Surg, 2018 Nov;53(11):2312-2317.
PMID: 29459045 DOI: 10.1016/j.jpedsurg.2018.01.004

BACKGROUND/PURPOSE: Although ultrasound-guided hydrostatic reduction (USGHR) is increasingly used in managing pediatric intussusception, there is limited literature concerning its use in Malaysia. We aim to examine the experience and factors associated with the effectiveness of USGHR using water.
METHODS: This is a single-center retrospective observational study in a Malaysian tertiary referral center. Children with intussusception admitted between year 2012 and 2016 were included and medical records reviewed. Factors associated with success or failure of USGHR were identified using multivariable logistic regression.
RESULTS: Of the 172 cases included, 151 cases (87.8%) underwent USGHR, of whom 129 cases were successfully reduced (success rate of 85.4%). One perforation (0.7%) was reported. Age more than 3years old (aOR=7.16; 95% CI=1.07-47.94; p=0.042), anemia (aOR=10.12; 95% CI=1.12-91.35; p=0.039), thrombocytosis (aOR=11.21; 95% CI=2.06-64.33; p=0.005) and ultrasound findings of free fluid (aOR=9.39; 95% CI=1.62-54.38; p=0.012) and left-sided intussusception (aOR=8.18;95% CI=1.22-54.90, p=0.031) were independently associated with USGHR irreducibility. Symptom duration, blood in stool, vomiting and other clinical presentations, however, showed no association.
CONCLUSIONS: USGHR with water is effective in the non-operative management of pediatric intussusception. Prolonged symptom duration need not necessarily preclude USGHR. The findings of anemia and thrombocytosis as independent predictors of USGHR irreducibility deserve further study.
TYPE OF STUDY: Treatment study LEVEL OF EVIDENCE: III.

Matched MeSH terms: Enema/methods*
Fulltext Rare and lethal complication of barium enema intravasation

Loo GH, Marzuki F, Henry F

BJR Case Rep, 2018 Dec;4(4):20180017.
PMID: 30931138 DOI: 10.1259/bjrcr.20180017

Barium enema investigation is regarded as a safe investigative procedure. Rarely, it may cause complications such as colonic perforation and barium intravasation. Barium intravasation may be caused by the inadvertent introduction of the catheter into the vagina, thereby into the vaginal venous plexus. It may also occur through mechanical colonic perforation with the catheter, or via diseased bowel conditions. This may lead to complications such as liver microabscesses, massive pulmonary embolism, hypovolemic shock, disseminated intravascular coagulopathy and even sudden death. With that in mind, we would like to report an interesting case of barium intravasation into the portal venous system via the vagina venous plexus. The patient experienced abdominal discomfort with mild per vaginal bleed and went into disseminated intravascular coagulopathy. She received supportive management and she made a full recovery.

Matched MeSH terms: Barium Enema
Inhibition of Microlax-induced experimental diarrhoea with narcotic-like extracts of Psidium guajava leaf in rats

Lutterodt GD

J Ethnopharmacol, 1992 Sep;37(2):151-7.
PMID: 1434689

Measurement of rates of propulsion in the small intestine in control and experimental groups of male Sprague-Dawley rats (200-250 g) were carried out as a means of assessing antidiarrhoeal activity of aqueous extracts of the leaf of Psidium guajava (L.), using morphine as the standard drug of reference. Hyperpropulsion (diarrhoea) was induced by gavaging rats in a control group with Microlax, using phenol red mixed into it as a marker in the intestine, and the mean rate of the hyperpropulsion was determined. The normal rate of propulsion, defined as the percentage of the length of the ileum traversed by the front of the dye in 1 h after gavaging animals with a liquid paraffin-phenol red meal, was also determined in another control group. In experimental groups pretreated with enteral administration of either morphine or aqueous extracts, 1 h before the challenge with Microlax, the percentage inhibition to the hyperpropulsive rate (antidiarrhoeal activity) was calculated. Both morphine and the extracts produced a dose-response relationship in their antidiarrhoeal effects. A dose of 0.2 ml/kg fresh leaf extract produced 65% inhibition of propulsion. This dose is equiactive with 0.2 mg/kg of morphine sulphate. The antidiarrhoeal action of the extract may be due, in part, to the inhibition of the increased watery secretions that occur commonly in all acute diarrhoeal diseases and cholera.

Matched MeSH terms: Enema
Fulltext Chronic Back Pain in a Young Female Patient: A Case of Ependymoma Originating from the Conus Medullaris

Asahar SF, Malek KA, Zohdi WNWM, Peter AB

Korean J Fam Med, 2020 Jan;41(1):68-72.
PMID: 31902199 DOI: 10.4082/kjfm.18.0157

We present the case of a 14-year-old Malay girl with an ependymoma of the conus medullaris who presented to multiple general practitioner clinics with a 24-month history of chronic low back pain. The pain was symptomatically managed as a simple musculoskeletal pain and sciatica. Further imaging to aid diagnosis was delayed until the appearance of severe pain with neurological deficits. Magnetic resonance imaging revealed an enhancing spinal mass at L1 through L3, and histopathological investigations confirmed the grade II ependymoma according to the World Health Organization classification. She underwent gross resection of the tumor. After the surgery, she developed neurogenic urinary bladder and bowel, which required intermittent self-catheterization, intermittent enema use, and intensive physical therapy.

Matched MeSH terms: Enema
Pharmacotherapy for chronic hemorrhagic radiation proctitis

Gul YA, Prasannan S, Jabar FM, Shaker AR, Moissinac K

World J Surg, 2002 Dec;26(12):1499-502.
PMID: 12297939 DOI: 10.1007/s00268-002-6529-8

Endoscopic thermal therapy and formalin are being increasingly recommended for the treatment of chronic hemorrhagic radiation proctitis. It may be too early, however, to discard pharmacologic agents from the management process, especially in medical institutions where specialized equipment is unavailable. We prospectively assessed the effectiveness of medical therapy in 14 consecutive patients with chronic hemorrhagic radiation proctitis from July 1999 to June 2001. All 14 subjects were women (mean age 56 years), 13 of whom had had radiotherapy for cancer of the cervix. The median time to onset of symptoms following irradiation was 16 months. Six patients had a hemoglobin level of < 8 g/dl, and blood transfusion was required in 11 patients. In five patients (36%) initially treated with hydrocortisone enemas prior to referral, this treatment continued; and the remaining nine patients were commenced on sucralfate enemas. Two patients given rectal hydrocortisone continued to bleed and were treated with sucralfate enemas and topical formalin, respectively. Rectal sucralfate suspension effectively procured symptomatic alleviation in all 11 patients. Rectal bleeding recurred in two patients who had been managed exclusively with hydrocortisone and sucralfate enemas, respectively, over a mean follow-up of 6 months. Both patients were managed with topical formalin, which controlled their symptoms. Even though the number of subjects in this study is small, sucralfate enema can be recommended as an effective first-line agent for managing patients with chronic hemorrhagic radiation proctitis. The use of more specialized therapy can therefore be reserved for cases where primary treatment failure occurs with sucralfate therapy.

Matched MeSH terms: Enema