scholarly journals Diagnosis and treatment of acute bowel obstruction

2013 ◽  
Vol 94 (3) ◽  
pp. 377-381
Author(s):  
A M Khadjibaev ◽  
N A Khadjimukhamedova ◽  
F A Khadjibaev

Aim. To improve treatment outcomes in patients with acute bowel obstruction. Methods. 1479 patients with bowel obstruction (75.7% - small bowel obstruction, 24.3% - large bowel obstruction) were examined. Patients were treated according to the local treatment protocol, 1003 (68%) patients underwent surgery. Results. The following procedures were performed at the stage of bowel obstruction diagnosis and treatment: conventional adhesiolysis was performed in 425 cases, laparoscopic adhesiolysis - in 425 cases, small bowel resection with further anastomosis - in 151 cases, small bowel resection with ileostomy - in 15 cases, phytobezoar fragmenting - in 56 cases, enterotomy and phytobezoar removal - in 2 cases. In patients with large bowel obstruction the following procedures were performed: large bowel segmental resection with further anastomosis - in 38 cases, large bowel segmental resection with colostomy - in 38 cases, large bowel partial resection with colostomy - in 54 cases, right hemicolectomy with primary anastomosis - in 43 cases, left hemicolectomy with primary anastomosis - in 58 cases, manual intussusception reduction - in 65 cases, side anastomosis - in 31 cases. In 69 cases of bowel obstruction primary anastomosis was performed using the metal ring frame. Conclusion. To reduce the rate of complications, the need for the surgery should be diagnosed as soon as possible, coagulopathies should be compensated, and surgery tactics should be defined, including the primary anastomosis formation.

2021 ◽  
Vol 8 ◽  
Author(s):  
Gunadi ◽  
Wahyu Damayanti ◽  
Robin Perdana Saputra ◽  
Ramadhita ◽  
Ibnu Sina Ibrohim ◽  
...  

Background: Meckel diverticulum (MD) is the most common congenital anomaly of the intestines, with an incidence of 2% of the general population. It can present as various clinical features with complications and be life threatening if diagnosis is delayed and treatment late.Case Presentation: We report three pediatric cases with complicated MD: one female presented with small-bowel obstruction, one male with peritonitis, and one female with severe iron-deficiency anemia, without gross gastrointestinal bleeding nor any ectopic gastric mucosa. All patients underwent exploratory laparotomy, segmental small-bowel resection, and primary anastomosis. They successfully recovered and were uneventfully discharged on the fourth, seventh, and 10th postoperative days, respectively.Conclusions: MD can present with various complication spectrums, including small-bowel obstruction, peritonitis, and severe iron-deficiency anemia, which may cause difficulty in definitive diagnosis, particularly in children. Segmental small-bowel resection and primary anastomosis are effective surgical approaches and show good outcomes for MD patients.


2016 ◽  
Vol 10 (1) ◽  
pp. 67-71 ◽  
Author(s):  
Glenn Harvin ◽  
Adam Graham

Sclerosing mesenteritis falls within a spectrum of primary idiopathic inflammatory and fibrotic processes that affect the mesentery. The exact etiology has not been determined, although the following associations have been noted: abdominal surgery, trauma, autoimmunity, paraneoplastic syndrome, ischemia and infection. Progression of sclerosing mesentritis can lead to bowel obstruction, a rare complication of this uncommon condition. We report a case of a 66-year-old female with abdominal pain who was noted to have a small bowel obstruction requiring laparotomy and a partial small bowel resection. The pathology of the resected tissue was consistent with sclerosing mesenteritis, a rare cause of a small bowel obstruction. Sclerosing mesenteritis has variable rates of progression, and there is no consensus regarding the optimal treatment. Physicians should consider sclerosing mesenteritis in the differential diagnosis of a small bowel obstruction.


2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Federica Vernuccio ◽  
Dario Picone ◽  
Gregorio Scerrino ◽  
Massimo Midiri ◽  
Giuseppe Lo Re ◽  
...  

Background. To compare sensitivity of unenhanced computed tomography (CT) and contrast-enhanced CT for the identification of the etiology of bowel obstruction. Materials and Methods. We retrospectively evaluated abdominal CT scans of patients operated for bowel obstruction from March 2013 to October 2017. Two radiologists evaluated CT scans before and after contrast agent in two reading sessions. Then, we calculated sensitivity of CT in the diagnosis of bowel obstruction and determined in which cases the etiology of bowel obstruction was detected on both unenhanced and enhanced CT or on enhanced CT only. The reference standard was defined as the final diagnosis obtained after surgery. Results. Eighteen patients (mean age 72±15 years, age range 37-88 years) were included in the study. Sensitivity of unenhanced CT and enhanced CT was not significantly different in either small bowel obstruction (64%, 7/11 patients vs. 73%, 8/11 patients; P=0.6547) or large bowel obstruction (71%, 5/7 patients vs. 100%, 7/7 patients; P=0.1410). Adhesions were identified on unenhanced CT as the etiology of small bowel obstruction in 80% (4/5) of patients. Tumors were identified on unenhanced CT as the etiology of large bowel obstruction in 67% (4/6) of patients. Conclusion. In the diagnosis of small bowel obstruction due to adhesions with normal bowel wall thickening and when a neoplasm is identified as the etiology of large bowel obstruction on unenhanced CT, an intravenous contrast agent may be avoided for the identification of the etiology. In remaining cases, contrast agent is still recommended.


1983 ◽  
Vol 28 (3) ◽  
pp. 265-272 ◽  
Author(s):  
Ernest Urban ◽  
Peggy E. Starr ◽  
Anna M. Michel

Digestion ◽  
1983 ◽  
Vol 26 (4) ◽  
pp. 224-230 ◽  
Author(s):  
Helen D. Wilson ◽  
Harold P. Schedl

2018 ◽  
Vol 5 (4) ◽  
pp. 1310
Author(s):  
N. K. Jaiswal ◽  
Sandeep Shekhar ◽  
Pushkar Ranade

Background: Acute intestinal obstruction is one of the major surgical emergencies. Intestinal obstruction is defined as partial or complete interference with forward flow of small or large intestinal contents. Intestinal obstruction of either small or large bowel continues to be a major cause of morbidity and mortality. Study aims to find the aetiology, diagnosis and management of acute intestinal obstruction.Methods: A total of 135 patients of acute intestinal obstruction was studied from November 2013 to October 2015 in government medical college, Nagpur. Study was done in patients in OPD of this tertiary centre. Inclusion criteria being patients coming to the hospital with features suggestive and further confirmed of acute intestinal obstruction. Patients included were in, age group of 18 years to 80 years giving written informed consent. Patient of pseudo obstruction were excluded from the study.Results: A total of 135 patients, presented with acute intestinal obstruction during the period of the study. Mean patient age was 45.87 years with peak incidence in those aged 21-30years. The foremost signs and symptoms were constipation (85.93%) and abdominal pain (91.11%). Adhesions and bands (61.9%) was the leading causes of intestinal obstruction.Conclusions: Present study concluded that small bowel obstruction is more common than large bowel obstruction. Abdominal pain, constipation and distension are the most common symptoms, while increased bowel sounds, tachycardia and tenderness is most common sign. Post-operative adhesion in small bowel and malignancy in large bowel is major cause of acute intestinal obstruction.


2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
K Aloni ◽  
H Harris ◽  
G Colucci ◽  
M McFall

Abstract A 57-year-old man presented to the emergency department with severe abdominal pain. Three months prior to presentation, he had sustained blunt trauma to his right side whilst cycling but had not sought medical attention. On admission, a CT scan showed small bowel obstruction and he underwent an emergency laparotomy. Intraoperatively, a subcapsular liver haematoma was identified, with incarcerated, necrotic small bowel within the liver capsule. The patient underwent deroofing of the haematoma with an omental patch and a small bowel resection with primary anastomosis. Small bowel obstruction is a common presentation in A&E and is responsible for half of emergency laparotomies in the UK each year. Although hepatic haematomas are also a relatively common complication of blunt trauma to the abdomen, associated bowel herniation into the liver capsule is very unusual. We believe this is the first time such a case of small bowel obstruction has been reported in the literature and we discuss details of operative management and highlight key learning points.


2021 ◽  
Vol 14 (4) ◽  
pp. e241632
Author(s):  
Kymberlie Aloni ◽  
Holly Harris ◽  
Gianluca Colucci ◽  
Malcolm McFall

A 61-year-old man presented to the emergency department with severe abdominal pain. Three months prior to presentation, he had sustained blunt trauma to his right side while cycling, but had not sought medical attention. On admission, a CT scan showed small bowel obstruction (SBO) and he underwent an emergency open laparotomy. Intraoperatively, a subcapsular liver haematoma was identified, with incarcerated, necrotic small bowel within the liver capsule. The patient underwent deroofing of the haematoma with an omental patch and a small bowel resection with primary anastomosis. We believe this is the first reported case of SBO secondary to small bowel herniation into the liver capsule following trauma.


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