scholarly journals Small Bowel Obstruction Caused by Tubo-Ovarian Abscess Following Chronic Pelvic Inflammatory Disease: A Case Report

2021 ◽  
Author(s):  
Yanan Li ◽  
Xiao Zhang ◽  
Yaxuan Zhao ◽  
Zhiqiang Zhang ◽  
Li Meng ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Abdominal Cavity ◽  
Local Treatment ◽  
Intestinal Loop ◽  
Dense Adhesion ◽  
Intestinal Tube ◽  
Pale Yellow ◽  
Ovarian Abscess

Abstract BackgroundAlthough there are reports of small bowel obstruction (SBO) secondary to tubo-ovarian abscess (TOA), there have been no documented cases of unexpected SBO, multiple intestinal ruptures and adhesions in a patient with chronic PID followed by successful surgical treatment of TOA who was successfully treated by surgery after failure by conservative treatment.Case presentationA 40-year-old female was admitted with main complaint of abdominal pain and fever for six days. A pelvic mass measuring 6.37x7.85x9.04 cm and ascites at rectovaginal pouch were found despite local treatment with metronidazole and cefazolin. Laboratory tests revealed leukocytosis of 8.9x10^9/L with hyper-neutrocytophilia of 82.8%, C-reactive protein increase at 223 mg/L and Procalcitonin 0.14ng/L. The patient was diagnosed with an acute attack of chronic PID. Tests and body temperature improved after 4 days of IV antibiotics. However, two days later, the patient presented abdominal distension, poor appetite, and difficulty in defecation. Abdominal CT suggested possibility of bowel obstruction. Accordingly, an explorative laparoscopy was performed, revealing 500ml pale yellow ascites within the abdominal cavity. The intestinal tube was clearly dilated with poor peristalsis. Multiple intestinal ruptures and adhesions were found. Dense adhesion existed between the intestinal loop and posterior uterus wall, closing the rectouterine pouch. Pale yellow thick pus could be seen from the end of fallopian tube, and part of the right ovary showed serious pyosis. All the adhesions were split, ruptures were repaired and normal anatomy was restored. Postoperative pathology indicated acute and chronic inflammation of both fallopian tubes with focal abscess formation. The patient was discharged 15 days after operation and followed up at one month without any symptoms.ConclusionIn such cases, close attention should be paid to changes in the patient’s condition and lesion changes. Early laparoscopy is advised when there are significant clinical or CT scan signs of bowel obstruction in TOA patients. Precise predictors or a predictive model for the need of invasive intervention to TOA will require further investigation.

scholarly journals A new method for insertion of long intestinal tube for small bowel obstruction

Medicine ◽  
2016 ◽  
Vol 95 (47) ◽  
pp. e5449 ◽  
Author(s):  
Kazuma Sekiba ◽  
Tomoya Ohmae ◽  
Nariaki Odawara ◽  
Makoto Moriyama ◽  
Sachiko Kanai ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
New Method ◽  
Intestinal Tube ◽  
Long Intestinal Tube

scholarly journals Laparoscopy in Management of Children with Small Bowel Obstruction

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
A O Dvorakevych ◽  
A A Pereyaslov ◽  
Yu I Tkachyshyn
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Rapid Development ◽  
Abdominal Cavity ◽  
Ileocecal Valve ◽  
Adhesive Small Bowel Obstruction ◽  
Adhesive Properties ◽  
Postoperative Complication Rate ◽  
Common Causes

Small bowel obstruction caused by adhesions is one of the most common causes of hospital admission among children. Until recently, the presence of symptoms of small bowel obstruction was the contraindication for laparoscopy; however, rapid development of minimally-invasive surgery determined the implementation of these methods in the management of patients with small bowel obstruction.The objective of the research was to summarize our own experience of laparoscopic treatment of children with small bowel obstruction.Materials and methods. The study is based on the results of laparoscopic management of 86 children being operated on during 2007-2015. Laparoscopy was used in 90.7% of patients and laparoscopically assisted procedures were performed in 9.3% of cases. Results. Adhesive small bowel obstruction occurred more often after laparotomy (70.9%), while after laparoscopy it was detected in 16.3% of patients only. During surgical revision of the abdominal cavity, single obstructive bands often in the area of the ileocecal valve were found in 55.8% patients; diffuse dense bands were observed in 31.4% of children; in 12.8% of children twisting of a loop of small bowel around the Meckel’s diverticulum was noted. Laparoscopically assisted procedures were applied in cases that required bowel resection. The postoperative complication rate was 9.3%.Conclusions. In the presence of appropriate skills, laparoscopic adhesiolysis can be a real alternative to conventional laparotomy in treating children with small bowel obstruction. The usage of remedies with anti-adhesive properties improves the results of treating children with bowel obstruction.

scholarly journals Delayed primary fascia closure of Björck grade 4 open abdomen with enteroatmospheric fistulas after repeated surgery for adhesive small bowel obstruction: a case report

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoshimasa Akashi ◽  
Koichi Ogawa ◽  
Kaoru Sasaki ◽  
Jaejeong Kim ◽  
Tsuyoshi Enomoto ◽  
...  
Keyword(s):  
Small Bowel ◽  
Parenteral Nutrition ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Open Abdomen ◽  
Abdominal Cavity ◽  
Wound Management ◽  
Adhesive Small Bowel Obstruction ◽  
Proximal Site ◽  
Fascia Closure

Abstract Background An open abdomen with frozen adherent bowels is classified as grade 4 in Björck’s open abdomen classification, and skin grafting after wound granulation is a typical closure option. We achieved delayed primary fascia closure for a patient who developed open abdomen with enteroatmospheric fistulas due to severe adherent small bowel obstruction. We present here the details of his management. Case presentation A 52-year-old man suffered acute abdominal pain during a flight and received an emergency laparotomy due to adhesive small bowel obstruction. Repeated laparotomies were required, and later open abdomen and proximal site jejunostomy were selected. After negative pressure wound therapy, he was transferred to our institution. Two enteroatmospheric fistulas emerged on the exposed intestine, and we diagnosed the condition as a Björck grade 4 open abdomen. After 8 months of wound care and parenteral nutrition, we decided to attempt primary wound closure because the patient required permanent oral restriction and total parenteral nutrition due to short bowel syndrome. A circular incision along the circumference of the exposed bowel allowed us to take a safe approach into the abdominal cavity. We removed the intestinal adhesions completely and resected the bowels, including the fistulas and anastomosed parts. Finally, the abdominal wall defect was reconstructed using the component separation technique, and the patient was discharged without an ostomy. Conclusions Primary fascia closure for grade 4 open abdomen is hard, but leaving a long interval before radical surgery and applying pertinent wound management may help solve this adverse situation.

Sign in / Sign up

Export Citation Format

Share Document