Colonic anastomotic disruption in the immediate postoperative period

Hirst, G. R.; Karandikar, Sharad; Brown, G. M.; Slowey, H. F.; Beynon, J.

doi:10.1007/s00384-003-0564-2

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…[4] Neostigmine stops hydrolysis of acetylcholine through bonding with cholinesterases; in addition, it increases peristaltic movements and intraluminal pressure by affecting the intestinal soft muscles due to its muscarinic effects. [10] Intestinal perforation after use of neostigmine was found in the two cases in the literature, one in which neostigmine was used and the development of intestinal perforation was related to the use of steroids, [11] and the other case in which the development of an anastomotic leak in the patient after hemicolectomy was related to the anticholinesterases used; [12] no cases involving children were found.…”

Section: Discussionmentioning

confidence: 99%

Neonatal transient myasthenia gravis and a case with intestinal perforation

Bekdaş¹,

Altunhan²,

Göksügür³

et al. 2015

Int J Med Sci Public Health

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A 2280 g female infant was born by cesarean delivery at 31 weeks of gestation to a 27-year-old mother with MG. Baby was shifted to newborn intensive care unit for hypotonia, tachypnea, and intercostal retractions starting after birth. The physical examination and chest X-ray were consistent with respiratory distress syndrome. The baby received exogenous surfactant (beractant 100 mg/kg) and was ventilated on synchronized intermittent mandatory ventilation mode. Neostigmine test was performed on the baby to facilitate separation of the baby from mechanical ventilator as her mother was known to be having MG. The test result was positive. Therefore, neostigmine treatment (0.01 mg/kg/h) began at 41st hour of hospitalization. The baby's abdomen distention developed at 56th hour of hospitalization. The finding of direct abdomen X-ray was consistent with intestinal perforation [Figure 1]. A colostomy was performed. Neostigmine was stopped as its effects in increasing risk of intestinal perforation were known. Pathology result was consistent with spontaneous intestinal perforation. No serious complication developed afterwards and the patient was extubated on her 19th day of hospitalization. The patient was discharged with full recovery after her general condition improved on the 35th day of hospitalization. Transient neonatal myasthenia gravis (MG) is observed in babies born to mothers with MG. Hypotony and respiratory distress are the most important warning signs observed in these babies. Anticholinesterases are used in the treatment. In this study, we present a case diagnosed with transient neonatal MG that has developed intestinal perforation after neostigmine treatment.

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Section: Discussionmentioning

confidence: 99%

Neonatal transient myasthenia gravis and a case with intestinal perforation

Bekdaş¹,

Altunhan²,

Göksügür³

et al. 2015

Int J Med Sci Public Health

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“…Postoperative ileus (delayed gastric emptying after surgery) can arise from the surgical procedure itself, anesthetic agents, opioid medications and other factors. Neostigmine can accelerate gastric emptying, but some studies suggest it contributes to adverse bowel effects, e.g., serious leaks from intestinal anastomoses [64,65]. Similarly, conditions such as functional dyspepsia, gastroparesis and colonic pseudo-obstruction may be treated with a cholinesterase inhibitor such as acotiamide 66–68].…”

Section: Cholinesterases and Pharmacological Effects Of Inhibitormentioning

confidence: 99%

Cholinesterases and the fine line between poison and remedy

Pope

Brimijoin

2018

Biochemical Pharmacology

107

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Acetylcholinesterase (AChE, EC 3.1.1.7) and butyrylcholinesterase (BChE, EC 3.1.1.8) are related enzymes found across the animal kingdom. The critical role of acetylcholinesterase in neurotransmission has been known for almost a century, but a physiological role for butyrylcholinesterase is just now emerging. The cholinesterases have been deliberately targeted for both therapy and toxicity, with cholinesterase inhibitors being used in the clinic for a variety of disorders and conversely for their toxic potential as pesticides and chemical weapons. Non-catalytic functions of the cholinesterases (ChEs) participate in both neurodevelopment and disease. Manipulating either the catalytic activities or the structure of these enzymes can potentially shift the balance between beneficial and adverse effect in a wide number of physiological processes.

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