scholarly journals Bowel decompression in the treatment of patients with acute colonic obstruction

2019 ◽  
Vol 23 (3) ◽  
pp. 420-424 ◽  
Author(s):  
V.V. Nepomniashchyi
Keyword(s):  
Motor Activity ◽  
Intestinal Obstruction ◽  
Motor Function ◽  
Colonic Obstruction ◽  
Acute Intestinal Obstruction ◽  
Intestinal Lumen ◽  
Intestinal Intubation ◽  
Number Of Patients ◽  
Intestinal Decompression ◽  
Medical Histories

According to literature data acute intestinal obstruction is characterized by a great number of neglected forms comprising 5–70% cases with the given pathology. A number of radiological signs in the way of Kloiber’s bowls and intestinal arches simply confirm this and testify of colon motor activity decompensation. To date there are no objective diagnostic criteria providing indications to intestinal decompression before the operation. Intestinal intubation, its types and indications to its fulfilment are based only on the experience and intuition of the operating surgeon. Aim — to define clinical efficiency of the intestinal wall impaired contractility diagnostics method in the treatment of patients with acute colonic obstruction. Medical histories analysis of 166 patients with obstructive intestinal obstruction was carried out. Assessment of intestinal motor activity compensation was carried out with the help of echographic criteria — the number of enlarged small bowel loops, intestinal lumen width, wall thickness, distance between Kerckring folds, number of peristaltic movements per minute. According to the suggested method 3 groups of patients were distinguished — with compensated motor activity (32 (19%) patients), with sub-compensated motor activity (61 (36.5%) patients) and with intestinal decompensated motor activity (73 (44.4%) patients). Wherein the greater number of patients with obstructive ileus (135 (81%) patients) got into the hospital with sub- and decompensated intestinal motor function. In the group of patients with compensated muscular tone intestinal decompression was not carried out, in the second group with sub-compensated intestinal tone decompression was carried out simultaneously in 13 (7.8%) patients, and in 9 (5.4%) a nasojunal probe was installed for 2–3 days, in the third group intestinal intubation was done in 63 (38%) patients. Post-operative mortality was 3.2%. Thus, echographic criteria allow establishing the degree of intestinal impaired motor function before the operation in patients with acute intestinal obstruction which decompression depends upon its state.

scholarly journals EXPERIENCE OF STAGED SURGICAL TREATMENT OF ACUTE OBSTRUCTIVE INTESTINAL OBSTRUCTION OF TUMOR ORIGIN

2021 ◽  
pp. 37-41
Author(s):  
M. A. Kashtalyan ◽  
V. Y. Shapovalov ◽  
R. V. Yenin ◽  
M. О. Koshicov ◽  
S. O. Pasternachenko
Keyword(s):  
Surgical Treatment ◽  
Elderly Patients ◽  
Intestinal Obstruction ◽  
Stent Placement ◽  
Colonic Obstruction ◽  
Vital Signs ◽  
Acute Intestinal Obstruction ◽  
Clinical Center ◽  
Tumor Origin ◽  
The Military

Summary. Objective: to improve the results of surgical treatment of patients with acute intestinal obstruction of tumor origin. Materials and methods of research. During the period from 2014 to 2020 in the surgical clinics of the Military Medical Clinical Center of the Southern Region (Odessa) 186 patients were treated with acute obstructive colonic obstruction of tumor origin. Research results and their discussion. In 34 (18.3 %) patients with GOKN during the applied conservative measures positive dynamics was observed, which allowed to examine patients in detail and prepare for surgery. In 6 (3.2 %) elderly patients with severe comorbidities, tumor recanalization and stent placement were performed. In 146 (78.5 %) patients, conservative measures were unsuccessful and were operated on according to vital signs, the first stage of which was intestinal fatigue. Conclusions. Step-by-step tactics of surgical treatment of acute intestinal obstruction of tumor origin with the use of laparoscopic colostomy in the first stage were used in 60.3 % of patients, which allowed final verification of the diagnosis, safe compensation of electrolyte and nutritional disorders in the patient and further treatment and correction.

scholarly journals Spontaneous Transmural Migration of a Retained Surgical Mop into the Small Intestinal Lumen Causing Sub-Acute Intestinal Obstruction: A Case Report

2011 ◽  
Vol 19 (1) ◽  
pp. 34-37
Author(s):  
Md Moniruzzaman Sarker ◽  
AKM Golam Kibria ◽  
Md Manzurul Haque ◽  
Kali Prosad Sarker ◽  
Md Khalilur Rahman
Keyword(s):  
Intestinal Obstruction ◽  
Acute Intestinal Obstruction ◽  
Intestinal Lumen ◽  
College Hospital ◽  
Medical College ◽  
Transmural Migration ◽  
History Of ◽  
Small Intestinal ◽  
The Right ◽  
Surgery Department

A case of sub-acute intestinal obstruction due to spontaneous complete transmural migration of a retained surgical mop into the small intestinal lumen has been treated surgically in surgery department of Rajshahi Medical College Hospital. The patient presented with colicky abdominal pain, nausea, occasional abdominal distention and vomiting. She had history of abdominal operation twice previously. Abdominal examination revealed a mobile lump in the right side of abdomen. Diagnosis could be made only at laparotomy.   doi: 10.3329/taj.v19i1.3167 TAJ 2006; 19(1): 34-37

scholarly journals ONCOLOGICAL OPERATIONS IN EMERGENCY SURGERY (CLINICAL CASE)

2021 ◽  
pp. 29-33
Author(s):  
K.V. Atamanov ◽  
◽  
V.E. Voitsitsky ◽  
O.A. Tkachuk ◽  
V.A. Lebedeva ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Postoperative Complications ◽  
Intestinal Obstruction ◽  
Clinical Case ◽  
Positive Outcome ◽  
Acute Intestinal Obstruction ◽  
Major Surgery ◽  
Number Of Patients ◽  
Combined Interventions

The increase in the incidence of colorectal cancer cannot go unnoticed. The number of patients with its complications in general surgical hospitals is growing steadily. The main ones include acute intestinal obstruction, bleeding, tumor destruction with paracancerous abscess formation or perforation. This limits the possibilities of carrying out the radical treatment of oncoproctological patients significantly, and reduces the number of resection interventions considerably. The incidence of postoperative complications in emergency patients is statistically higher than after elective surgeries. The most fatal is the failure of the enterocolonic anastomosis, usually requiring relaparotomy and often colostomy. With regional tumors, combined interventions are necessary, a prerequisite for which is the availability of trained specialists. The article presents a clinical case of performing a major surgery with a positive outcome for complicated colon cancer in a hospital on duty.

scholarly journals A Study on Raised Serum LDH Level in Acute Intestinal Obstruction – A Marker of Bowel Gangrene

2020 ◽  
Vol 3 (1) ◽  
pp. 120-123
Author(s):  
Anantha Kumar Nateson ◽  
Suresh Nayak Basavanayak ◽  
Sudarsan Srikanth
Keyword(s):  
Intestinal Obstruction ◽  
Venous Blood ◽  
Cost Effective ◽  
Abdominal Distension ◽  
Serum Levels ◽  
Acute Intestinal Obstruction ◽  
Number Of Patients ◽  
Study Results ◽  
Bowel Gangrene ◽  
Aseptic Conditions

Background: Bowel gangrene is a major abdominal catastrophe associated with high mortality rate. Intestinal obstruction accounts for 20%   of all surgical emergencies around the world. The present study aims to estimate the LDH levels in patients with acute intestinal obstruction and correlate with bowel viability. Subjects and Methods: In this study, the estimation of serum LDH was conducted in 45 cases of acute intestinal obstruction who were admitted in surgical wards. After fulfilling the inclusion and exclusion criteria the study subjects were recruited. All the cases were thoroughly examined. Time of presentation and onset of symptoms were noted. Under aseptic conditions, 3 ml venous blood samples were collected from the study subjects, centrifuged at 3000 rpm and separated serum sample was used for the estimation of lactate dehydrogenase (LDH) and the estimated value of serum LDH is compared with the viability of the bowel intra operatively. Results: The total number of patients presented with obstruction is 45 out of which 25 were found to have elevated LDH which is about 55.56%. Out of 25 patients presented with elevated LDH, 20 patients found to have gangrenous bowel. 60% presented with abdominal pain and 40% had irreducible swelling. Most commonly associated symptoms are vomiting (84%) followed by abdominal distension (40%), obstipation (36%), pyrexia (24%), blood in stools (8%) and diarrhoea (4%). Per rectal examination showed 76% had normal faecal staining, 12% blood stained faeces and 8% empty. Complications observed were anastomotic leak 8%, wound infection 16%, wound gaping 8%, burst abdomen 8%. Conclusion: The present study results indicate that ischemic changes in any part of the bowel can cause elevation in the serum levels of LDH and a higher value of >1000 IU/L strongly indicates an underlying gangrenous change. It is a less invasive, cost effective and easily available diagnostic tool to diagnose bowel ischemia/gangrene. Hence it is more useful in centres where the diagnostic facilities are limited.

scholarly journals Diagnosis and surgical treatment of acute intestinal obstruction caused by extragenital form of endometriosis

2020 ◽  
Vol 12 (1) ◽  
pp. 97-101
Author(s):  
Zemlyanoy V. Р. P. Zemlyanoy ◽  
B. V. Sigua ◽  
D. S. Syomin ◽  
D. V. Gurzhiy ◽  
D. H. Qalandarova
Keyword(s):  
Surgical Treatment ◽  
Gastrointestinal Tract ◽  
Intestinal Obstruction ◽  
Sigmoid Colon ◽  
Clinical Laboratory ◽  
Acute Intestinal Obstruction ◽  
Intestinal Lumen ◽  
Childbearing Age ◽  
Surgical Department ◽  
Extragenital Endometriosis

Damage to the gastrointestinal tract with extragenital endometriosis is a very rare pathology. According to the literature, the frequency of damage to the gastrointestinal tract in endometriosis, after previously performed gynecological operations, is less than 1%. At the same time, involvement in the pathological process of the intestine is noted in 337% of women of childbearing age with diagnosed genital endometriosis. In most clinical cases extragenital endometriosis occurs intraoperatively due to the complexity of early diagnosis. This article presents a clinical case of successful surgical treatment of a 43-year-old patient admitted to a surgical department with signs of intestinal obstruction. According to the anamnesis the patient had been suffering from recurrent pains in the lower abdomen in the right mesogastrium and constipation. The day before hospitalization, the above mentioned symptoms become worse with additional nausea, vomiting, lack of gases and feces. Based on the clinical laboratory and instrumental data the diagnosis of acute intestinal obstruction was established; and the urgent surgical treatment was carried out. Two formations were revealed intraoperatively (in the terminal ileum and in the elongated loop of the sigmoid colon). Both formations circularly narrowed the intestinal lumen, however the ileum was the cause of obstruction. Due to the lack of histological verification and the inability to exclude the malignant nature of the formation, the surgical treatment was carried out taking into account oncological standard in the amount of ileum resection and obstructive resection of the sigmoid colon with lymphadenectomy and small intestine intubation. Pathohistological examination confirmed intestinal endometriosis. The course of the postoperative period revealed no complications. The patient was discharged on the 12th day for outpatient treatment under the supervision of a surgeon and a gynecologist at the place of residence with recommendations and subsequent planned hospitalization in order to conduct reconstructive surgery to restore intestinal patency.

scholarly journals Abdominal tuberculosis: a surgical emergency

2017 ◽  
Vol 5 (9) ◽  
pp. 3847
Author(s):  
Rajandeep Singh Bali ◽  
Rahul Jain ◽  
Yawar Zahoor ◽  
Ankul Mittal
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Surgical Management ◽  
Surgical Intervention ◽  
Tertiary Care ◽  
Acute Intestinal Obstruction ◽  
Care Hospital ◽  
Number Of Patients ◽  
Management Protocol ◽  
Operative Findings

Background: To study and assess the clinico-pathologic profile, intra-operative findings, surgical intervention performed and outcome in terms of morbidity and mortality of the patients included in the study group.Methods: This study was carried out at Lok Nayak Hospital and Maulana Azad Medical College, New Delhi, a tertiary care hospital between November 2011 to March 2015. It was a retrospective study in which the records of the patients operated upon in the emergency department as peritonitis or acute intestinal obstruction and whose diagnosis was later confirmed as tuberculosis on histopathology were analysed with regards clinic-pathologic profile, intra-operative findings, surgical intervention performed and outcome in terms of morbidity and mortality.Results: The mean age of our study group was 28.7 years. 70% of our patients were found to be in the underweight category and 30% were in the normal category. Fourty three (56.6%) presented to the hospital with features suggestive of peritonitis and thirty-three (43.4) were suffering from acute intestinal obstruction. The commonest intra-operative finding encountered was ileal perforation followed by multiple small bowel perforations, solitary stricture of the small bowel with perforation, ileo-cecal mass, adhesions or bands, single or multiple strictures, stricture with impending small bowel perforation and jejunal perforation. The frequently performed surgical procedures were ilesotomy, resection and anastamosis of the involved bowel, primary repair of thr perforation, right hemicolectomy, adhesiolysis, stricturoplasty (done in case of single stricture, mostly), jejunostomy and peritoneal and omental biopsy.Conclusions: Tuberculosis is a very grave disease, studies with larger number of patients need to be conducted to standardise its surgical management as at present there is no standardised surgical management protocol.

scholarly journals THE ROLE OF HYPOTHERMIA IN ACUTE ADHESIONS INTESTINAL OBSTRUCTION

ASJ. ◽  
2021 ◽  
Vol 1 (50) ◽  
pp. 13-16
Author(s):  
M. Magomedov ◽  
M. Magomedov
Keyword(s):  
Intensive Care ◽  
Intestinal Obstruction ◽  
Acute Intestinal Obstruction ◽  
Study Group ◽  
Ischemic Damage ◽  
Laboratory Parameters ◽  
Results Of Treatment ◽  
Intestinal Contents ◽  
Intestinal Decompression

Results of intensive care of 68-patients (39- male, 28 female, aged from 23 to 86 years) with intestinal obstruction are summarized. All the patients were divided into two groups: 1st (study) group consisted of 30 patients who have been treated with hypothermal enteral sanation, patients of 2nd group (38 have been treated with intestinal decompression only. Results of treatment were compared by clinical and laboratory parameters. It is demonstrated that intestinal intubation and hypothermal sanation at acute intestinal obstruction are effective methods for elimination of toxic intestinal contents, prevent ischemic damage and stimulate peristalsis of intestinum. The positive final results after this treatment are demonstrated. Lethality was 10,5 and – 21%.

scholarly journals A clinical study of surgical management of acute intestinal obstruction

2018 ◽  
Vol 5 (10) ◽  
pp. 3342
Author(s):  
Gayathri V. ◽  
Praveen Mali ◽  
Harindranath H. R.
Keyword(s):  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Acute Intestinal Obstruction ◽  
Emergency Laparotomy ◽  
Hernia Surgery ◽  
Number Of Patients ◽  
General Surgeons ◽  
Mechanical Bowel Obstruction ◽  
The Common ◽  
Obstructed Hernia

Background: Mechanical bowel obstruction remains one of the most common intra-abdominal problems faced by general surgeons in their practice and continues to be a major cause of morbidity and mortality.Methods: This retrospective study was carried out on data obtained from 50 patients who underwent emergency laparotomy for acute intestinal obstruction in Victoria and Bowring and Lady Curzon Hospital from January 2016 to December 2016.Results: Adhesions (26%) were found to be the most common cause followed by obstructed hernia (22%). The common age group was 51-60 years. The commonest symptom was abdominal pain followed by vomiting and constipation. The average duration of presentation was 2 days. Strangulation was found in 20% of cases. Mortality rate in the study was 16%.Conclusions: In conclusion, we have found that adhesions are becoming an ever-increasing underlying cause of bowel obstruction. A trend of elective hernia surgery has reduced the number of patients of hernias presenting with obstruction of bowel.

scholarly journals Determination of intestinal viability in acute intestinal obstruction

1981 ◽  
Vol 62 (5) ◽  
pp. 62-64
Author(s):  
V. V. Podkamenev ◽  
V. N. Shatunov
Keyword(s):  
Intestinal Obstruction ◽  
Mucous Membrane ◽  
Motor Function ◽  
Intestinal Wall ◽  
Acute Intestinal Obstruction ◽  
Nerve Cells ◽  
The State ◽  
Ischemic Area ◽  
Sufficient Detail

In determining the intestinal viability, errors leading to fatal outcomes range from 16.4 to 22.1% [1, 4, 8]. Therefore, the search for ways to objectively assess the state of the ischemic area of ​​the intestine is relevant.Morphological changes in the intestine in this pathology have been studied in sufficient detail. It was found that the basis for the violation of intestinal viability is hemocirculatory disorders, which cause necrosis of the intestinal wall. The latter, as a rule, begins with the mucous membrane and gradually spreads to all layers. Severe dystrophic changes in nerve cells develop, leading to a persistent disorder of the intestinal motor function. Already after 6-9 hours, deep changes in the choroid and nerve plexuses appear in the restrained loop of the intestine.

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