scholarly journals Clinical Analysis of the Curative Effect of a Transnasal Ileus Tube in the Treatment of Small Bowel Obstruction Caused by a Phytobezoar

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Yong-Xu Lin ◽  
Sun-Jian Wang ◽  
Hui-Shun Liang ◽  
Su Lin ◽  
Li-Yong Bian ◽  
...  
Keyword(s):  
Small Bowel ◽  
Conservative Treatment ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Albumin Level ◽  
Tube Placement ◽  
Curative Effect ◽  
Duration Of Symptoms ◽  
Conservative Group ◽  
Significant Difference

Objective. To investigate the curative effect of a transnasal ileus tube in the treatment of small bowel obstruction caused by a phytobezoar. Methods. Seventy-one patients with small bowel obstruction caused by a phytobezoar who underwent treatment in three provincial tertiary grade A hospitals in Fujian Province from March 2011 to February 2020 were included in this study. Patients were divided into the following two groups according to the treatment received: (1) conservative group, comprising patients who received medical conservative treatment, and (2) combined group, including patients who received combined medical conservative treatment and transnasal ileus tube placement. The clinical symptoms, changes in abdominal imaging, tube depth of the first day, reduction of pressure volume on the first day after catheterization, length of hospital stay, and nonsurgical rate were compared between the combined and conservative groups. Results. There was no significant difference in age, sex, history of previous abdominal surgery and abdominal radiotherapy, symptoms at admission, duration of symptoms before admission, signs at admission, laboratory data, and obstruction position between the combined and conservative groups. There was a statistically significant difference in the nonsurgical rate (19/24 vs. 23/47, P = 0.014 ) between the combined and conservative groups. Logistic analysis showed that the duration of symptoms before admission, albumin level, and use of a transnasal ileus tube might be independent factors affecting the transition to surgery for patients with small bowel obstruction caused by a phytobezoar ( P < 0.05 ). Conclusion. Timely conservative medical treatment with transnasal ileus tube placement can effectively improve the nonsurgical rate of small bowel obstruction caused by a phytobezoar. The duration of symptoms before admission, albumin level, and use of a transnasal ileus tube were closely related to whether patients with small bowel obstruction caused by phytobezoar were transferred to surgery.

scholarly journals Therapeutic Role of Gastrograffin in Adhesive Small Bowel Obstruction After Unsuccessful Conservative Treatment

Med Phoenix ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 26-31
Author(s):  
MD Alam Shahid ◽  
Pashupati Bhatta ◽  
Akash Raya ◽  
Binod Kumar Rai
Keyword(s):  
Small Bowel ◽  
Conservative Treatment ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Open Appendectomy ◽  
Sampling Technique ◽  
Exploratory Laparotomy ◽  
Water Soluble ◽  
Adhesive Small Bowel Obstruction ◽  
Therapeutic Role

Background: The management of adhesive small bowel obstruction is quite debatable. Gastrograffin, a water-soluble hyperosmolar contrast is used as a diagnostic tool widely but it also has impressive therapeutic role. Hence this study was to determine its therapeutic role in management of adhesive bowel obstruction after failure of conservative treatment. Methods: This cross-section observational study of 42 patients was conducted in 1-year duration from 01 July 2018 to 30 June 2019 using non-probability purposive sampling technique. All the patients were first managed conservatively for 48 hrs, and then given 100ml of gastrograffin through NG tube and clamped. Appearance of dye in cecum on radiograph at different time frame (4, 8, 12 and 24 hours of administration) signifies the success and who failed to do so within 24 hrs. were planned for laparotomy. Results: A total of 42 patients with their age ranged 14-80 years (mean 44.6) were included. Among them 32 (76.19%) were male and 10 (23.80%) female. Most had open appendectomy followed by gynaecological surgery and exploratory laprotomy. Majority had midline incision followed by gridiron and pfanensteil incision. After 8 hrs of gastrograffin administration, it was positive in 12 patients while 19 had at 24 hrs. Total 31 patients showed complete resolution, while remaining 11 showed no improvement and undergone exploratory laparotomy. Conclusion: Thus, the administration of gastrograffin is an effective approach in the management of adhesive small bowel obstruction after failed conservative management and prevents surgeries.  

scholarly journals Hand-Sewn versus Stapled Closure of Loop Ileostomy: A Meta-Analysis

2018 ◽  
Vol 36 (3) ◽  
pp. 183-194 ◽  
Author(s):  
Rana Madani ◽  
Nigel Day ◽  
Lalit Kumar ◽  
Henry S. Tilney ◽  
Andrew Mark Gudgeon
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Anastomotic Leak ◽  
Bowel Obstruction ◽  
Group Performance ◽  
Bowel Resection ◽  
Loop Ileostomy ◽  
Complication Rates ◽  
Definitive Answer ◽  
Significant Difference

Background: Individual trials comparing hand-sewn with stapled closure of loop ileostomy show different outcomes due to lack of statistical power. A systematic review, with a pooled analysis of results, might provide a more definitive answer. This review aimed to compare hand-sewn with stapled anastomotic technique for closure of a loop ileostomy and looked at the effect of bowel resection on the complication rates. Methodology: Relevant studies were identified from MEDLINE, EMBASE and the Cochrane database. All randomised clinical trials, prospective and retrospective studies comparing hand-sewn with stapled closure of loop ileostomy were included. Results: Of the 4,917 patients in 15 identified studies, 3,406 had hand-sewn and 1,511 stapled anastomosis. There was no difference in the rate of anastomotic leak between the hand-sewn (2.93%, 55/1,877) and the stapled group (2.08%, 25/1,202) (OR 0.81, 95% CI 0.43–1.54, p = 0.52, I2 = 33%). The rate of small-bowel obstruction was higher in the hand-sewn group (7.03%, 231/3,284) compared to the stapled group (5.58%, 73/1,308; OR 0.69, 95% CI 0.51–0.92, p = 0.01, I2 = 0%). There was no difference in the incidence of anastomotic leak and small-bowel obstruction in the hand-sewn anastomosis between patients with or without bowel resection. Conclusions: There was no significant difference in the rate of anastomotic leakage between the hand-sewn and stapled techniques. The rate of small-bowel obstruction was higher in the hand-sewn group. Performance of bowel resection does not significantly increase the incidence of anastomotic leak or small-bowel obstruction.

New approaches in conservative treatment of acute adhesive small bowel obstruction

2021 ◽  
pp. 45
Author(s):  
S.E. Larichev ◽  
S.G. Shapovalyants ◽  
B.G. Zavyalov ◽  
A.V. Shabrin ◽  
D.A. Omelyanovich ◽  
...  
Keyword(s):  
Small Bowel ◽  
Conservative Treatment ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Adhesive Small Bowel Obstruction ◽  
New Approaches

Water-Soluble Contrast Media in Radiography of Small Bowel Obstruction

1988 ◽  
Vol 29 (1) ◽  
pp. 53-56 ◽  
Author(s):  
A. Stordahl ◽  
F. Laerum ◽  
T. Gjølberg ◽  
I. Enge
Keyword(s):  
Small Bowel ◽  
Contrast Media ◽  
Contrast Medium ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Water Soluble ◽  
Double Blind ◽  
Peritoneal Adhesions ◽  
Significant Difference ◽  
Better Than

Fifty patients with possible gastrointestinal obstruction, referred for enteric follow-through examination, were randomized for a double-blind, parallel comparison of the hyperosmolar contrast medium Gastrografin and the low-osmolar Omnipaque. The result was that Omnipaque retained its radiographic density in the small bowel better than Gastrografin. Omnipaque was thus a better alternative than Gastrografin in follow-through examinations of intestinal obstruction. Also, 23 patients out of 28 with small bowel obstruction due to peritoneal adhesions, had spontaneous relief of symptoms during the observation period following contrast medium ingestion with no significant difference between the two media. This indicated that enteric follow-through procedures may have a therapeutic efficacy similar to the treatment of small bowel obstruction using nasogastric suction and gastrointestinal rest. Possible mechanisms for this action of the contrast media are discussed.

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