scholarly journals Rare Forms of Intestinal Obstruction in Children

2019 ◽  
Vol 4 (2) ◽  
pp. 144-147 ◽  
Author(s):  
V. N. Stalmakhovich ◽  
I. N. Kaigorodova ◽  
A. S. Strashinsky ◽  
I. B. Li ◽  
E. V. Sapukhin
Keyword(s):  
Small Intestine ◽  
Intestinal Obstruction ◽  
Abdominal Cavity ◽  
Clinical Signs ◽  
Pancreatic Injury ◽  
Esophageal Stenosis ◽  
X Ray ◽  
First Child ◽  
Omental Bursa ◽  
Adhesive Intestinal Obstruction

The article analyzes two rare cases of acquired intestinal obstruction in children. In the first child at the age of 2 years, who suffered a retrosternal total coloesophagoplasty for extended post-burn chemical esophageal stenosis, early postoperative adhesive intestinal obstruction appeared on the 8th day of the postoperative period, which was eliminated laparoscopically. The next day, against the background of drug stimulation of the intestine, a small intestinal invagination developed, diagnosed with ultrasound examination. Relaparotomy and disinvagination were performed.The second patient, the 15 years old girl, who had suffered from closed abdominal injury and a pancreatic injury, manifested the signs of high partial intestinal obstruction a day after the trauma occurred. Initially, its cause was considered to be hematoma of the omental bursa. Fibrogastroduodenoscopy (FGDS) and X-ray diagnostics did not reveal the cause of intestinal obstruction, but after FGDS procedure the patient’s condition improved within 3–4 days, and then the clinical signs of small bowel obstructive adhesion confirmed by X-ray and laparoscopy. With laparoscopy in the middle section of the small intestine, a hyperinflate “whitish” section about 12 cm long, dense in palpation, was identified, which was the cause of obstruction. Through minilaparotomic umbilical access from the abdominal cavity, a loop of the jejunum with a foreign body inside was exteriorized. With transverse enterotomy trihobezoar 10×4×4 cm was removed from the lumen, which moved from the stomach and led to obstruction of small intestine. The outcome of the treatment was good in both cases.

scholarly journals Modern methods for adhesive bowel obstruction diagnosis

2021 ◽  
Author(s):  
K. D. Rybakov ◽  
G. S. Sednev ◽  
E. M. Askerov ◽  
A. M. Morozov ◽  
A. N. Pichugova ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Small Intestine ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Resonance Imaging ◽  
X Ray ◽  
Modern Methods ◽  
Partial Colectomy ◽  
Adhesive Intestinal Obstruction

Topicality. Adhesive intestinal obstruction is a common disease in abdominal surgery with a significant increase from year to year. During the last 20 years, the frequency of cases of adhesive intestinal obstruction (SCN) has increased by 2 times and has no tendency to decrease. In the UK, small bowel obstruction was an indication for 51% of all emergency laparotomies. Scott et al. reported seven emergency surgeries, accounting for 80% of all hospital admissions, morbidity, mortality, and health care costs in relation to general surgery in the United States. These seven operations included partial colectomy, small bowel resection, cholecystectomy, peptic ulcer surgery, adgeolysis, appendectomy, and laparotomy. Adhesive intestinal obstruction of the small intestine was the most frequent diagnosis in the behavior of four out of seven surgical interventions (partial colectomy, resection of the small intestine, adgeolysis and laparotomy). Postoperative adhesive processes are the main cause of small intestine obstruction, accounting for 60% of cases. Among all cases of intestinal obstruction, acute small intestine is 64.3–80%, while having a severe course and a worse prognosis. This causes a high mortality rate in this pathology. It ranges from 5.1% to 8.4%, occupying a leading place among all urgent diseases.The purpose of the study was to evaluate various modern methods of diagnosing adhesive intestinal obstruction.Material and methods. In this study, the method of classical analysis of domestic and foreign literature was applied, based on current data on the diagnosis of adhesive intestinal obstruction.Results. Historically, there has been a certain algorithm for examining patients arriving with suspected adhesive intestinal obstruction, which includes: complaints, anamnesis of the disease and life, objective status, as well as additional diagnostic methods. Patients with OCD usually present a wide range of complaints, such as nausea, vomiting and periodic abdominal pain. Nausea and vomiting follow the appearance of pain and are an early sign of proximal adhesive OCN. However, clinical symptoms are only partially able to diagnose adhesive intestinal obstruction. Laboratory data are of little significance in the diagnosis of intestinal obstruction, but they help to determine the presence and severity of metabolic disorders, homeostasis disorders, as well as to indicate possible starngulation. For the diagnosis of OCN, OBP survey radiography is routinely used. Computed tomography (CT) has a higher sensitivity and specificity compared to abdominal X-ray examination and is recommended by the Bologna Guidelines. Ultrasound examination (ultrasound) is increasingly used in the diagnosis of OCD. Ultrasound is a relatively simple inexpensive non-invasive imaging method that is devoid of radiation exposure, but depends on the operator's experience. To minimize the effects of ionizing radiation in children and pregnant women, magnetic resonance imaging is an effective alternative to computed tomography for intestinal obstruction.Conclusion. The problem of adhesive intestinal obstruction remains highly relevant, given the prevalence of the disease and high mortality rates. Currently, new promising methods for diagnosing this disease, including biomarkers and high-tech methods for visualizing the pathological process, such as computed tomography and magnetic resonance imaging, are acquiring high importance. At the same time, one should not forget about the routine research methods – X-ray of the abdominal cavity and classical methods of examining the patient – collecting complaints, anamnesis and determining the objective status. 

scholarly journals About criteria of X-Ray study in chronic palace disease of Bruceur

2018 ◽  
Vol 11 (2) ◽  
pp. 97-100
Author(s):  
Marat A Nurtdinov ◽  
Ildar F Sufiayrov ◽  
Gusel R Yamalova ◽  
Aiaz A Shakirianov
Keyword(s):  
Small Intestine ◽  
Surgical Treatment ◽  
Intestinal Obstruction ◽  
Intestinal Wall ◽  
Virtual Model ◽  
Peritoneal Adhesion ◽  
Peritoneal Disease ◽  
X Ray ◽  
Pearson Criterion ◽  
Adhesive Intestinal Obstruction

The problem of determining indications for surgical treatment for peritoneal peritoneal disease is relevant in connection with the lack of reliable criteria that allow us to detect intestinal obstruction at early stages. The authors studied the x-ray picture of chronic peritoneal peritoneal disease in two groups of patients, without obstruction (6 patients) and in the group of patients with obstruction (5 patients). X-ray computer tomography diagnostics was carried out using the Aquilion RXL, Toshiba Japan, VitreaAdvanced software was used to build the virtual model. For the comparative analysis, nonparametric statistics were used to calculate the Pearson criterion, with the Yates correction. The authors proposed the criteria of X-ray tomographic examination, which allow differentiating the adhesive intestinal obstruction from exacerbation of peritoneal adhesion. To these signs, the authors refer, pneumatized loops of the intestine, the presence of fluid in the lumen of the small intestine, the accumulation of fluid more than 200.0 ml, in two or more areas, thickening of the intestinal wall more than 2.1 mm. It was shown that the use of the developed complex of symptoms in the diagnosis of the disease positively affects the results of surgical treatment.

scholarly journals Early diagnostics of acute honestious intestinal incapability with help of X-ray tomography

2018 ◽  
pp. 55-59
Author(s):  
I. F. Sufiyarov ◽  
F. F. Mufazalov ◽  
G. R. Yamalova
Keyword(s):  
Intestinal Obstruction ◽  
Surgical Intervention ◽  
Abdominal Cavity ◽  
Intestinal Wall ◽  
Peritoneal Adhesion ◽  
Peritoneal Disease ◽  
X Ray ◽  
Pearson Criterion ◽  
X Ray Computed ◽  
Adhesive Intestinal Obstruction

The most important problem determining the indications for surgical treatment of peritoneal adhesion is associated with the uncertainty of the criteria for early diagnosis of intestinal obstruction. Of all the most common acute surgical diseases of the abdominal cavity, acute intestinal obstruction gives the highest lethality. The main reason for this is untimely diagnosis. In two groups of patients, we performed a study of chronic peritoneal peritoneal disease using X-ray computed tomography (RCT), with obstruction (58 patients) and absence of this pathology (56 patients). Analyzing nonparametric statistics with the calculation of the Pearson criterion, with the Yates correction. We presented the criteria for the RCT study, differential diagnosis of adhesive intestinal obstruction from exacerbation of peritoneal adhesion. The main indicators of this disease: the fluid content in the lumen of the small intestine is more than 200.0 ml, in two or more regions, the inflated intestinal loops, an extension of 2.1 mm and more of the intestinal wall. The validity of the diagnostic criteria for RCT research leaves no doubt about the need for their use in preoperative access prognosis and the scope of surgical intervention.

Introducing into the small intestine the abdominal compress left in the abdominal cavity

1930 ◽  
Vol 26 (9) ◽  
pp. 939-939
Author(s):  
H. Biesenberger
Keyword(s):  
Small Intestine ◽  
Intestinal Obstruction ◽  
Abdominal Cavity ◽  
X Ray

Abstracts. Surgery and X-ray therapy. Introduction into the small intestine of an abdominal compress left in the abdominal cavity. N. Biesenberger (Zentr. F. Chir., 1930, No. 29) gives a case operated on for intestinal obstruction. Four months ago, the patient was operated on in another place for pyosalpinx'a. All the time after the operation, the patient felt pains in the abdomen, which have recently become more frequent and intensified. Over the last week, the pains have become cramping and intense.

Treatment of adhesive intestinal obstruction

1980 ◽  
Vol 61 (5) ◽  
pp. 53-54
Author(s):  
I. I. Kluev ◽  
V. S. Belikov ◽  
V. I. Kluev
Keyword(s):  
Intestinal Obstruction ◽  
Abdominal Cavity ◽  
Adhesive Intestinal Obstruction ◽  
Surgical Clinic

Of the 896 patients admitted to the surgical clinic of the Mordovian University in 1967-1976. for intestinal obstruction, 507 (56.6%) had adhesive intestinal obstruction or adhesive disease of the abdominal cavity. Adhesive disease of the abdominal cavity can occur at any age, but more often - from 20 to 50 years. The time elapsed from the operation to the onset of symptoms, adhesions (pain attacks), in 52 patients did not exceed 1 month, in 80 it was from 2 to 6 months, in 186 - from 6 months to 1 year, in 142 - from 1 year up to 5 years and in 47 - from 5 to 10 years or more.

scholarly journals The Point-Rating Scale for Determining Treatment Tactics in Patients With Adhesive Small Bowel Obstruction

2021 ◽  
Vol 10 (2) ◽  
pp. 303-308
Author(s):  
B. V. Sigua ◽  
V. P. Zemlyanoy ◽  
B. P. Filenko ◽  
P. A. Kotkov ◽  
D. Kh. Kalandarova ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Conservative Therapy ◽  
Rating Scale ◽  
Negative Impact ◽  
Morphological Changes ◽  
Abdominal Cavity ◽  
Adhesive Small Bowel Obstruction ◽  
Point Rating Scale ◽  
Adhesive Intestinal Obstruction ◽  
Therapy Success

Relevance. The most practiced method of treating patients with acute intestinal obstruction - urgent surgical intervention - does not guarantee remission, contributing to the progression of morphological changes in the abdominal cavity. From this perspective, a shift in emphasis towards the planned surgical treatment of patients with adhesive disease with the use of the existing anti-adhesive methods after conservative resolution of the intestinal passage disorders looks like a promising direction.Aim of the study. Improving the results of patients with acute adhesive intestinal obstruction treatment by developing a point-rating scale that allows to highlight groups of patients who are prone to conservative resolution of intestinal passage disorders episode, and, thereby, reduces the proportion of urgent interventions.Material and methods. The analysis of the 125 patients treatment results (retrospective group) admitted with symptoms of acute adhesive intestinal obstruction was carried out. On this basis, the point-rating scale was developed including a number of factors that have certain value in terms of predicting the probability of conservative therapy success. Subsequently the developed scale was applied in 170 patients (prospective group) as part of treatment tactics implementation aimed at maximally conservative resolution of adhesive intestinal obstruction without negative effect on the immediate results of patients operated in later periods.Results. The developed point-rating scale made it possible to reduce the frequency of urgent interventions among patients with signs of acute adhesive intestinal obstruction (from 79.2% to 57.6%) due to longer conservative measures — 18.1±17.2 and 11,2±8.7 hours in prospective and retrospective groups, respectively). There was no negative impact on the frequency of resection interventions (12.2 and 16.1% in the prospective and retrospective groups) as well as postoperative complications and overall mortality.Conclusions. The developed point-assessment scale made it possible to stratify patients in accordance with the probability of conservative therapy success and to justify its continuation for more than 12 hours in low-risk patients. The obtained results allow us to recommend the proposed scale for use in clinical practice. 

scholarly journals HOSPITAL EPIDEMIOLOGY OF ABDOMINAL ADHESIONS

2016 ◽  
Vol 1 (4) ◽  
pp. 115-118 ◽  
Author(s):  
Аюшинова ◽  
Natalya Ayushinova ◽  
Шурыгин ◽  
Mikhail Shurygin ◽  
Шурыгина ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Clinical Symptoms ◽  
Abdominal Cavity ◽  
Abdominal Adhesions ◽  
Hospital Epidemiology ◽  
Surgical Interventions ◽  
Adhesive Intestinal Obstruction ◽  
Intestinal Fistulas ◽  
Regional Hospitals ◽  
Methods Of Treatment

The purpose of the research was to establish main causes of development and outcomes of adhesive obstruction.We analyzed the outcomes of treatment of 154 patients with acute intestinal obstruction. The following data were taken into consideration: age, gender, surgeries in past medical history, terms of adhesions manifestations, clinical symptoms, findings of additional examinations, methods of treatment, outcome. It has been established, that the most frequent causes of adhesions were appendectomy (23%), stomach operations (21 %) and gynecological interventions (14 %). After surgeries performed in conditions of regional hospitals, adhesions developed after appendectomy, gynecological operations and interventions on the intestine. In patients operated in city hospitals intestinal obstruction more often occurred after extensive operations on the stomach, appendix, and after gynecological interventions. Urgent surgical interventions more often led to adhesive process in the abdominal cavity (63 %). Mortality made 5.8 %. Causes of death were intestinal fistulas and abdominal sepsis.Thus, acute adhesive intestinal obstruction as an extreme form of abdominal adhesions continues to be an urgent medical issue.

scholarly journals NEW PROSPECTS OF DIAGNOSIS IN EMERGENCY ABDOMINAL SURGERY

2021 ◽  
pp. 47-51
Author(s):  
A. I. Shurma ◽  
F. V. Grinchuk ◽  
A. V. Motric
Keyword(s):  
Peptic Ulcer ◽  
Acute Appendicitis ◽  
Intestinal Obstruction ◽  
Blood Plasma ◽  
Optical Density ◽  
Abdominal Cavity ◽  
Venous Blood ◽  
Underlying Disease ◽  
Colon Perforation ◽  
Adhesive Intestinal Obstruction

Summary. Aim. Search for new methods for diagnosing acute surgical pathology of the abdominal cavity (ASPAC). Materials and methods. 39 patients: liver abscess — 4, acute appendicitis, periapendicular abscess — 3, acute appendicitis, perito-nitis — 5, acute phlegmonous appendicitis — 7, acute phlegmonous cholecystitis — 4, colon perforation, peritonitis — 3 , acute uncomplicated adhesive intestinal obstruction — 4, uncomplicated peptic ulcer — 4. Measured the optical density of venous blood plasma on a spectrophotometer SF-4A. The control was given to 8 patients (adhesive intestinal obstruction, uncomplicated peptic ulcer disease). Results and discussion. A number of maxima of the values of the optical density of the plasma at wavelengths λ = 3.1, 3.5, 4.3, 6.1, 6.7, 9, 17.5 micrometers were revealed. Indicators differed depending on the type of underlying disease and complications. For analysis and comparison, patients were divided into groups: abscesses, peritonitis, destructive pathology without peritonitis (appendicitis, cholecystitis) and control. At wavelengths λ = 3.1, 6.1, 6.7, 9, 17.5 micrometers, the optical density in patients with no destructive pathology is significantly lower than in patients with such pathology. In addition, the indicators differ in the presence of peritonitis, abscesses and uncomplicated destructive pathology. Conclusions. In the presence of acute surgical diseases of the abdominal cavity in patients, the specific maxima of the optical density of venous blood plasma in the infrared region at wavelengths λ = 3.1, 3.5, 4.3, 6.1, 6.7, 9, 17 , 5 micrometers. Changes in the parameters of optical density differ, depending on the characteristics of the underlying disease and complications and have common patterns in the perforation of hollow organs, abscesses, peritonitis, destructive uncomplicated diseases. Determination of optical density is a promising area for improving the diagnosis of ASPAC.

scholarly journals Acute rhabdomyolysis in a dog: Case report

2017 ◽  
Vol 73 (10) ◽  
pp. 675-678
Author(s):  
Roman Lechowski ◽  
Rafał Sapierzyński ◽  
Joanna Bonecka ◽  
Magdalena Ostrzeszewicz
Keyword(s):  
Intestinal Obstruction ◽  
Ultrasound Examination ◽  
Abdominal Cavity ◽  
Fluid Infusion ◽  
X Ray ◽  
First Case ◽  
Acute Rhabdomyolysis ◽  
Life Threatening ◽  
Critical Interpretation ◽  
Severe Weakness

In a 9-years-old Labrador retriever, signs of severe weakness and a dark brown colour of urine were observed. During clinical examination, pain of the abdominal cavity and muscles was noted. Abdominal x-ray and ultrasound examination revealed signs of intestinal obstruction. The activity of creatine kinase was 187380 U/l. The diagnosis of acute muscle damage was made. Treatment included antibiotic and analgesic therapy, as well as aggressive fluid infusion. No additional treatments were required, and the dog made a speedy recovery. The rapid and intensive treatment prevented acute renal failure, which is a life-threatening complication of acute rhabdomyolisis. This is the first case of acute idiopathic rhabdomyolysis in a dog in Poland. An early intensive fluid therapy and a critical interpretation of radiological signs of intestinal obstruction are crucial for successful therapy.

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