REVIEW OF THE OPERATIVE TECHNIQUE ADOPTED IN DETERMINING THE LOCATION OF INTESTINAL OBSTRUCTION, WITH THE SUGGESTION OF A SIMPLE AND SAFE METHOD.

Abstract Background Intussusception is the most common cause of intestinal obstruction between 6 months and 36 months of age. There is no defined etiology in at least 75-90% of patients. Recurrent intussusception occurs in 5-16% of all intussusceptions and the treatment strategy is controversial in this patient group. Treatment of continued recurrent intussusception is a challenging problem when no lead point is revealed despite recurrence. We aimed to review our 10 years of experience in recurrent intussusception and describe a new operative technique for recurrent intussusception cases without any lead points. Results We retrospectively reviewed the data of patients with recurrent intussusception in our referral pediatric surgery clinic between 2007 and 2017. Ultrasound-guided hydrostatic reduction was performed on all patients. Surgery was performed on those patients who had findings of acute abdomen and complete intestinal obstruction or 2 failed attempts of UGHR for diagnostic purposes if a pathologic lead point was suspected based on patient findings and age. Laparoscopy or laparotomy was performed according to surgeon preference and experience. A total of 87 UGHRs were performed. Thirty-three patients were admitted to our clinic due to recurrent intussusception. The mean age was 12.75±14.14 (6 -84) months, and 19 were males and 14 were females. Abdominal pain, agitation and vomiting were common symptoms. UGHR was performed on all 33 patients on at least 2 different occasions. The time between the first and second UGHR treatments was 42.6 ± 186.19 (0-899) days. The success rate of the second UGHR was 27 out of 33 patients (81.8%). Surgery was performed on 6 patients. Manual reduction was performed on 5 patients and one was operated by the laparoscopic reduction of intussusception and Meckel’s diverticulum resection. Conclusions Surgeons should try to find permanent solutions for patients with multiple recurrent intussusceptions that are resistant to treatment. Surgical excision of the lead point will help prevent recurrent intussusception. Satisfactory results can also be obtained by ultrasound-guided hydrostatic reduction even in patients with recurrences. Laparoscopy is helpful in diagnosis, detection of lead points and treatment of irreducible intussusception. This new operative technique can be satisfactory for recurrent intussusceptions without any lead points.

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Temporary auditory threshold shift following sophomore operative technique laboratory

Journal of Dental Education ◽

10.1002/j.0022-0337.1980.44.5.tb01362.x ◽

1980 ◽

Vol 44 (5) ◽

pp. 261-263

Author(s):

DC Bowman ◽

LJ Blanchet ◽

DB Doemling

Keyword(s):

Operative Technique ◽

Auditory Threshold ◽

Threshold Shift

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The Effect of Vomiting Due to Intestinal Obstruction on the Serum Potassium

Gastroenterology ◽

10.1016/s0016-5085(49)80005-9 ◽

1949 ◽

Vol 12 (1) ◽

pp. 49-56 ◽

Cited By ~ 13

Author(s):

Samuel Bellet ◽

Carl S. Nadler ◽

Peter C. Gazes ◽

Mary Lannzng

Keyword(s):

Intestinal Obstruction ◽

Serum Potassium

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Two Siblings with Total Colonic Aganglionosis Extended to the Ileum

Swiss Surgery ◽

10.1024/1023-9332.9.4.187 ◽

2003 ◽

Vol 9 (4) ◽

pp. 187-189

Author(s):

Aslan ◽

Caglar ◽

Karagüzel ◽

Melikoglu

Keyword(s):

Intestinal Obstruction ◽

Loop Ileostomy ◽

Good Condition ◽

Disease Type ◽

Definitive Treatment ◽

Entire Colon ◽

Total Colonic Aganglionosis ◽

Protective Ileostomy ◽

Definitive Surgery ◽

Partial Intestinal Obstruction

Total colonic aganglionosis (TCA) extended to the ileum is seen quite rare among infants with Hirschsprung's disease. Type and timing of definitive surgery in these patients are controversial. This report was presented to discuss the management of two siblings with TCA. Case 1: A two-day-old girl was operated for partial intestinal obstruction. During laparotomy, serial frozen biopsies proved TCA extended to the terminal ileum and a loop ileostomy was performed. At five months of age, a modified Duhamel-Martin procedure without protective ileostomy was performed. An endo-GIA stapler was transanally used for colo-ileal anastomosis. She is doing well for the last five years. Case 2: A one-day-old boy admitted to the hospital with similar findings to his sister. Frozen biopsies during first laparotomy proved that majority of ileum and entire colon was aganglionic and a proximal ileostomy was performed. At 10 months of age, he underwent a similar Duhamel-Martin operation. He is in a good condition for the last four years. Conclusion: In infants, our modification on Duhamel-Martin procedure, which is based on the use of an endo-GIA stapler transanally for colo-ileal anastomosis without protective ileostomy, may be utilized as an alternative method in the definitive treatment of patients with TCA.

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Types of Stressors on Nonprofessional Against-Suicide and Pro-Suicide Message Boards

Crisis ◽

10.1027/0227-5910/a000562 ◽

2019 ◽

Vol 40 (4) ◽

pp. 257-264 ◽

Cited By ~ 1

Author(s):

Thomas Niederkrotenthaler ◽

Benedikt Till

Keyword(s):

Content Analysis ◽

Interpersonal Problems ◽

Suicide Method ◽

Presenting Problems ◽

Message Boards ◽

Safe Method ◽

Different Types ◽

Psychiatric Problems

Abstract. Background: Little is known about presenting problems of primary posters (i.e., posters opening the thread) and their responders in nonprofessional against-suicide and pro-suicide message boards. Aims: We aimed to compare problems described in suicide message boards between different types of users (primary posters and respondents) and between against-suicide, neutral, and pro-suicide message boards. Method: In all, 1,182 archival threads with 20,499 individual postings from seven nonprofessional suicide message boards supporting an against-suicide, neutral, or pro-suicide attitude were randomly selected. Problems mentioned by primary posters and their respondents were coded with content analysis. Differences between pro-suicide, neutral, and against suicide boards, as well as correlations between primary posters and respondents, were calculated. Results: Interpersonal problems were most frequently mentioned by primary posters in against-suicide threads (40.9%) and less frequently in pro-suicide threads (11.8%; p < .001). In pro-suicide boards, the most frequent stressors were suicide method-related (e.g., how to identify a safe method: 26.2% vs. 2.5% in against-suicide boards, p < .001). Primary posters resembled respondents in terms of presenting problems in pro-suicide boards, but not in against-suicide boards. Limitations: Only self-reported problems were assessed. Conclusion: The results confirm a stronger focus on death than on life among users in pro-suicide message boards, and posters with similar problems meet in pro-suicide boards. The posters appear to clearly emphasize social strains over psychiatric problems compared with some professional settings.

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