scholarly journals MORPHOLOGICAL CHANGES OF THE SMALL INTESTINE IN ACUTE STRANGULATIVE INTESTINAL OBSTRUCTION IN THE STAGE OF DECOMPOSITION IN CHILDREN

2018 ◽  
Vol 8 (3) ◽  
pp. 28-33 ◽  
Author(s):  
A. E. Solovev ◽  
I. V. Vasin ◽  
O. А. Kul’chitskij
Keyword(s):  
Small Intestine ◽  
Intestinal Obstruction ◽  
Morphological Changes ◽  
Intestinal Resection ◽  
Intestinal Wall ◽  
Intestinal Necrosis ◽  
Morphological Studies ◽  
Intestinal Strangulation ◽  
Small Intestinal ◽  
Adhesive Obstruction

Purpose. The purpose was to determine the depth and prevalence of pathomorphological changes in the small intestine of children at the distance from the visible border of necrosis with decompensated acute strangulated intestinal obstruction (ASIO) to determine the minimum possible length of intestinal resection.Material and methods. Morphological studies of a resected fragment of the small intestine were performed in 24 children aged 3 days to 18 years who had undergone a surgery for ASIO with intestinal necrosis. Strangulated adhesive obstruction was found in 17 children, five children had congenital intestine torsion and two children faced small intestinal strangulation in the congenital mesenteric defect. The postsurgical material was studied morphologically using histological stains with the distance of 3 cm between the section.Results. The depth, prevalence of the morphological changes in the small intestinal wall, intensity and length of morphological changes in children with decompensated ASIO were determined.Conclusion. A differentiated approach to the selection of resection scope in the proximal and distal directions from the visible border of ASIO-related necrosis is necessary. The distances are twice shorter in children as compared to adults. Refusal from extensive resections will enable to reduce the rate of short bowel syndrome in children.

scholarly journals HOW TO DEFINE THE LEVEL OF INTESTINAL RESECTION IN COMPLICATED FORMS OF INTESTINAL OBSTRUCTION IN CHILDREN

2020 ◽  
Vol 24 (2) ◽  
pp. 78-82
Author(s):  
I. I. Babich ◽  
Yuri N. Melnikov
Keyword(s):  
Intestinal Obstruction ◽  
Russian Federation ◽  
Intestinal Resection ◽  
Intestinal Wall ◽  
Control Group ◽  
Intestinal Necrosis ◽  
Congenital Origin ◽  
Accelerated Rehabilitation ◽  
Medical Facilities ◽  
Local Necrosis

Introduction. The bowel (intestinal) obstruction is a very common case in pediatric surgical practice. Intestinal transit disorders in children are caused by organic or functional problems of congenital origin or by acquired pathology. The incidence of intestinal obstruction is steadily increasing. This is due to an increasing number of cases with congenital gastrointestinal tract malformations as well as to an increasing number and volume of surgical intestinal interventions. Materials and methods. 76 patients, aged 0 months - 14 years, with various forms of intestinal obstruction were taken into the study. All patients were divided into 2 groups. The control group had 30 patients who were treated in medical facilities of the first level; the studied group included 46 patients who were operated in our clinic. In patients from the studied group, the viability of intestine and the level of resection were defined using the original technique “ Detection of the area of local necrosis and the level of intestine resection in children with intestinal obstruction “ , patent No 2 690744, Russian Federation, developed on the basis of another patent No 2 594 978 of Russian Federation “A technique for modeling local intestinal wall necrosis in the experiment.” The technique is as follows: While performing electrical stimulation of the intestinal wall with neurostimulator HNS 12, one can see a characteristic funnel-shaped depression indicating intestinal necrosis. The level of resection is determined by moving the electrode from the central part of the studied zone to distal and proximal directions until the circular contraction of the intestine appears. Results. This technique prevented relaparotomies, reduced transfer to enteral feeding by 33%, reduced the incidence of prolonged intestinal paresis by 62.5%, reduced patients’ stay in ICU by 41% and postoperative hospital stay by 24% as well as accelerated rehabilitation process by 27.3%. Conclusion. The technique developed for detecting the area of local necrosis and the level of intestinal resection promotes a most careful resection of the affected area of the intestine till healthy tissues, as well as prevents complications requiring surgical correction.

scholarly journals Experimental substantiation of using a synthetic peptide in the complex surgical treatment of acute intestinal obstruction

2018 ◽  
pp. 138-140
Author(s):  
А.А. Коваленко ◽  
В.К. Хугаева
Keyword(s):  
Surgical Treatment ◽  
Intestinal Obstruction ◽  
Intestinal Anastomosis ◽  
Intestinal Wall ◽  
Acute Intestinal Obstruction ◽  
Study Objective ◽  
Doppler Flowmetry ◽  
Study Results ◽  
Small Intestinal

Высокая смертность при хирургическом лечении острой кишечной непроходимости (ОКН) определила поиск новых методов сопутствующей терапии. Обнаруженная ранее высокая эффективность опиоидных пептидов в стимулировании лимфотока в микрососудах брыжейки тонкой кишки у крыс, восстановлении нарушенной микроциркуляцию и снижении смертности при ряде заболеваний, определила цель данного исследования: изучить роль фармакологической стимуляции лимфотока в динамике ОКН. В работе использовали методы: биомикроскопия, лазерная допплеровская флоуметрия брыжейки и стенки тонкой кишки крысы, регистрация сократительной активности лимфатических микрососудов ЛМ методом фотометрии, морфометрия микрососудов, видео- и фотосъемка. Полученные результаты предполагают наличие адаптационной роли у активатора микролимфоциркуляции (опиоидного пептида-171 прямого действия) в комплексном хирургическом лечении ОКН. Однократное орошение пептидом межкишечного анастомоза (после удаления) и поврежденного лигатурой фрагмента кишки (перед зашиванием операционной раны) увеличивало выживаемость животных с ОКН на 23%. У всех выживших животных отмечено восстановление: проходимости кишки, микроциркуляции в кровеносных и лимфатических микрососудах, а также структуры стенки кишки. High mortality in the surgical treatment of acute intestinal obstruction (AIO) has warranted the search for new methods of concomitant therapy. Opioid peptides have proved highly effective in stimulating the lymphatic flow in rat small intestinal mesenteric microvessels, restoring the impaired microcirculation, and reducing mortality in many diseases. This had determined this study objective: to investigate the role of lymphatic stimulation in the dynamics of AIO. The study used methods of biomicroscopy, laser Doppler flowmetry, and histological examination of the mesentery and the small intestinal wall in rats; recording the contractile activity of lymphatic microvessels using photometry; microvessel morphometry; video and photography. The study results suggested an adaptive role of the lymphatic microcirculation activator (direct-action opioid-171) in the complex surgical treatment of AIO. A one-time peptide irrigation of the intestinal anastomosis (after removal) and the intestinal injuried by the ligature (before the surgical wound was sutured) increased the survival of animals with AIO by 23%. In all surviving animals, recovery of the intestinal patency, blood and lymphatic microcirculation, and the intestinal wall structure was observed.

scholarly journals Analysis of therapeutic results and complications after colic surgery in 434 horses

2008 ◽  
Vol 53 (No. 1) ◽  
pp. 12-28 ◽  
Author(s):  
J. Mezerova ◽  
Z. Zert ◽  
R. Kabes ◽  
L. Ottova
Keyword(s):  
Small Intestine ◽  
Postoperative Period ◽  
Paralytic Ileus ◽  
Abdominal Cavity ◽  
Adhesion Formation ◽  
Intestinal Resection ◽  
Colon Surgery ◽  
Common Finding ◽  
Intestinal Surgery ◽  
Small Intestinal

Out of the total number of 434 horses that underwent colic surgery, small intestine was operated in 195 (44.9%) patients, caecum in 10 (2.3%) horses, large colon surgery was performed in 196 (45.2%) cases and small colon surgery in 14 (3.2%) horses. In 12 patients (2.8%) two different parts of the gastrointestinal tract were affected simultaneously, one horse suffered from peritonitis, torsion of the uterus developed in two mares and three animals had negative surgical findings. Of 434 horses, 371 (85.5%) survived. After small intestinal surgery, 159 patients (81.5%) recovered from anaesthesia and were discharged home as well as seven horses (70%) after caecal surgery, 175 horses (89.3%) after large colon surgery and 14 horses (100%) following small colon surgery. 75 out of 103 horses (72.8%) were discharged home after the small intestinal resection and 89 of 98 horses (90.8%) with small intestinal problems where no resection was needed. In total, 43 of the patients that underwent one surgery did not survive the immediate postoperative period. The most frequent lethal complications in horses following the small intestinal surgery included peritonitis (five horses) and paralytic ileus (four horses) and in horses with large colon problems it was typhlocolitis (six cases). Relaparotomy was indicated in 41 of 434 horses (9.4%) that recovered from colic surgery. 21 out of the 41 (51.2%) relaparotomised colic patients were released from the clinic. All successfully repeated surgeries were carried out to overcome primary small intestine ileus problems, and in 14 of these cases (66.7%) resection and anastomosis were performed. The most common finding, diagnosed in 9 of 21 reoperated horses, was paralytic ileus. Of 20 relaparotomised horses that did not survive, three animals were lost after the introduction of anaesthesia, nine horses were euthanised after the abdominal cavity revision, one horse did not recover after the surgical procedure and seven horses did not survive the postoperative period. In 15 of 20 dead horses, the cause of the first surgical intervention was small intestinal ileus, in other four horses there was a large colon problem and in the last patient, it was a stomach disease. In 13 of 15 (86.7%) horses with small intestinal problems and in three of four (75%) patients with large colon disease, either resection or bypass was performed. In the remaining four non-surviving horses of 20 relaparotomised ones, peritonitis and/or adhesion formation was diagnosed at the second surgery, in three horses anastomosis complications were the main problem. Peritonitis or paralytic ileus led to death or euthanasia in four of seven horses that recovered after relaparotomy.

Intestinal strangulation after elective ovariohysterectomy

2010 ◽  
Vol 12 (4) ◽  
pp. 325-329 ◽  
Author(s):  
SY Kuan ◽  
K Ticehurst ◽  
KL Hoffmann ◽  
D Crosby ◽  
VR Barrs
Keyword(s):  
Small Intestine ◽  
Clinical Outcome ◽  
Intestinal Resection ◽  
Exploratory Laparotomy ◽  
Abdominal Ultrasound ◽  
Acute Onset ◽  
Midline Incision ◽  
Good Clinical Outcome ◽  
Intestinal Strangulation

A 6-month-old female spayed domestic shorthair cat was presented with an acute onset of vomiting and marked lethargy. The cat had undergone elective ovariohysterectomy via a small midline incision 2 weeks prior to presentation. Intestinal strangulation through a mesenteric rent was diagnosed via abdominal ultrasound and exploratory laparotomy. Intestinal resection and anastamosis resulted in a good clinical outcome despite excision of 60% of the small intestine.

CHOICE OF SURGERY TACTICS IN PATIENTS WITH HIGH RISK OF ANASTOMOTIC LEAK DEVELOPMENT

2020 ◽  
pp. 25-28
Author(s):  
M. Ye. Tymchenko
Keyword(s):  
Small Intestine ◽  
Surgical Treatment ◽  
Abdominal Cavity ◽  
Intestinal Resection ◽  
Surgery Complications ◽  
Intestinal Anastomoses ◽  
Post Surgery ◽  
Intestinal Stoma ◽  
Small Intestinal ◽  
Surgical Tactics

Intestinal resection is one of the most common surgeries performed on urgent indications, the most difficult is the decision in favor of the formation of primary anastomosis in the case of primary infection of abdominal cavity, multiple defects of the intestinal wall, as well as the general serious condition of a patient. In order to improve the methods of diagnosis and prevention of post−surgery complications, as well as personification of surgical tactics of treatment in the patients undergoing anastomotic surgeries in intestine, the results of treatment of 96 patients were analyzed. The level of serum cryoglobulins was determined by the method of A. E. Kalovidoris with modifications. The results of surgical treatment were evaluated according to the classification of D. Dindo et al. (2004). The use of cryoglobulin levels before surgery can significantly affect surgical tactics: at a low degree it is possible to perform resection of a segment of small intestine with the formation of primary small intestinal anastomoses; at average − it is possible to perform small−intestinal anastomoses with unloading intestinal stoma or with the location of the anastomosis extraperitoneally (if possible) and decompression of the anastomosis with an incubation probe; at high − it is expedient to supplement performance of an anastomosis with a variant of an enterostomy or "delayed" anastomoses, at a severe general condition of patients it is expedient to form final small intestinal stoma. Determining the level of cryoglobulinemia as a marker of the prognosis of failure of the sutures of intestinal anastomoses and the use of differentiated surgical tactics depending on the level of this index contributes to a significant improvement in direct results of surgical treatment of the patients undergoing resection of small intestine segments. The proposed tactics virtually eliminate the implementation of multi−stage surgical interventions and helps to reduce the duration of treatment of patients, reduce the level of post−surgery complications and mortality. Key words: cryoglobulinemia, surgical treatment, small intestine, anastomoses.

Parietal Strangulation Of Small Intestine In Femoral Hernia Site With Symptoms Of Intestinal Obstruction In Patient With Incidentally Found Small Intestine Tumor - A Case Report

2015 ◽  
Vol 87 (8) ◽  
Author(s):  
Andrzej Żyluk ◽  
Włodzimierz Majewski
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Small Bowel ◽  
Intestinal Wall ◽  
Mechanical Obstruction ◽  
Intestinal Necrosis ◽  
Femoral Ring ◽  
Luminal Tumour ◽  
Specific Symptoms ◽  
Symptoms And Signs

AbstractRichter’s hernia (partial enterocele) is the strangulation/entrapment of only part of the circumference of the intestinal wall. It is relatively rare, and presents without mechanical obstruction – giving vague, non-specific symptoms and signs, and a threat of intestinal necrosis, gangrene, followed by perforation. A report of a case of entrapment of the jejunum in the femoral ring, which did not cause the gangrene, but symptoms of mechanical obstruction, is presented. Further inspection of the small bowel in this case revealed an extra-luminal tumour, which appeared to be a GIST. The entrapped part of the jejunum has been released and the tumour has been resected.

scholarly journals Lipoma of the Small Intestine: A Cause for Intussusception in Adults

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Ketan Vagholkar ◽  
Rahulkumar Chavan ◽  
Abhishek Mahadik ◽  
Inder Maurya
Keyword(s):  
Small Intestine ◽  
Intestinal Obstruction ◽  
Preoperative Diagnosis ◽  
Surgical Intervention ◽  
Small Intestinal ◽  
Underlying Pathology ◽  
Early Surgical Intervention

Intussusception as a cause of intestinal obstruction in adults is rare. There is invariably an underlying pathology which leads to intussusception in adults. A case of intussusception in an adult due to a small intestinal lipoma is presented in view of this association. Ultrasound and CECT may help in a preoperative diagnosis. However early surgical intervention is the mainstay of treatment in order to confirm the diagnosis of the underlying pathology, thereby avoiding misdiagnosis of an underlying cancer.

scholarly journals Intestinal disaccharidase activities in the chick

1969 ◽  
Vol 112 (1) ◽  
pp. 51-59 ◽  
Author(s):  
R. C. Siddons
Keyword(s):  
Small Intestine ◽  
Large Intestine ◽  
Total Activity ◽  
Intestinal Wall ◽  
Lactase Activity ◽  
Middle Section ◽  
Ph Optimum ◽  
Ph Values ◽  
Small Intestinal ◽  
Intestinal Disaccharidases

1. Disaccharidase activities of the small and large intestines of the chick were studied. 2. Homogenates of the small intestine readily hydrolysed maltose, sucrose and palatinose (6-O-α-d-glucopyranosyl-d-fructose), hydrolysed lactose slowly and did not hydrolyse trehalose and cellobiose. 3. Within the small intestine the disaccharidases were located mainly in the intestinal wall; the activity in the contents accounted for less than 5% of the total activity. 4. The disaccharidases were non-uniformly distributed along the small intestine, the activities being greatest in the middle section. 5. The disaccharidase activities increased with age between 1 and 43 days. 6. Homogenates of the large intestine and contents readily hydrolysed maltose, sucrose, palatinose and lactose and hydrolysed cellobiose and trehalose slowly. 7. The large-intestinal disaccharidases were located mainly in the contents. 8. Similar Km and pH optimum values were found for the maltase, sucrase and palatinase activities of the large and small intestines. 9. The lactase activity of the large intestine was markedly affected by diet and had different Km and pH values from the small intestinal lactase. 10. Low activities of intestinal disaccharidase were found in 12-day-old embryos and marked increases in the intestinal disaccharidases of the developing embryo occurred 2–3 days before hatching.

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.

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