Large bowel obstruction during pregnancy: the efficacy of dietary fibers

Aim: to evaluate the clinical efficacy of dietary fibers and lactulose in pregnant women with large bowel obstruction. Patients and Methods: this prospective study included 60 pregnant women (20–24 weeks of pregnancy) with large bowel obstruction occurred during pregnancy and persisted for at least 3 months. All women were randomized and divided into two groups. Group 1 received soluble fibers and group 2 received group 2 received lactulose. Clinical efficacy of treatment was evaluated using a specialized questionnaire filled at baseline, 48 h, 4 days, and 14 days after starting treatment. Results: mean age was 27.1±4.0 years in group 1 and 28.3±5.0 years in group 2. Bowel evacuation less than 3 times a week occurred in 87% and 77%, respectively, the duration of pushing occupied more than 25% of defecation in 70% and 60%, respectively, hard stool occurred in 100%, anal fissures and a feeling of incomplete evacuation were reported in 47% and 57%, respectively. Comfort bowel evacuation 48 h after starting treatment was reported in 63% of women who received dietary fibers and 47% of patients who received lactulose. Normal defecation by day 4 was observed in 80% of women in group 1 and 53% in group 2. Treatment effect was achieved by day 14 in 87% in group 1 and 70% in group 2. The most common complaint was abdominal distension that occurred 3.5 times more common after treatment with lactulose (р<0.05). Conclusions: dietary fibers were more effective in terms of achieving the desired outcome and patient satisfaction. KEYWORDS: large bowel obstruction, defecation, pregnancy, dietary fibers, OptiFibere, lactulose. FOR CITATION: Dobrokhotova Yu.E., Borovkova E.I., Simonyan T.D., Selimshaeva D.S. Large bowel obstruction during pregnancy: the efficacy of dietary fibers. Russian Journal of Woman and Child Health. 2021;4(1):36–41. DOI: 10.32364/2618-8430-2021-4-1-36-41.

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A case of colonic gallstone ileus with a spontaneous evacuation

Health Renaissance ◽

10.3126/hren.v9i1.4363 ◽

1970 ◽

Vol 9 (1) ◽

pp. 47-49 ◽

Cited By ~ 1

Author(s):

A Bajracharya ◽

OP Pathania ◽

S Adhikary ◽

CS Agrawal

Keyword(s):

Bowel Obstruction ◽

Large Bowel ◽

Gallstone Ileus ◽

Abdominal Distension ◽

The Elderly ◽

Large Bowel Obstruction ◽

High Morbidity ◽

Diagnostic Challenge ◽

History Of ◽

Spontaneous Evacuation

Colonic gallstone is an uncommon entity with a high morbidity and mortality due to various reasons. It remains a diagnostic challenge because of delayed and non-specific presentations, especially in the elderly population, often with multiple co-morbidities. We present a case of colonic gallstone ileus with spontaneous evacuation in a 67 years female who had a threeday history of intermittent bouts of colicky abdominal pain, vomiting , constipation and progressive abdominal distension, features of large bowel obstruction treated non operatively for 72 hours and passage of the stone spontaneously. Keywords: gallstone ileus; large bowel obstruction; colonic gallstone DOI: 10.3126/hren.v9i1.4363Health Renaissance, 2011: Vol.9 No.1:47-49

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Pediatric sigmoid volvulus of an extremely long sigmoid colon with hypoganglionosis: a case report

Journal of International Medical Research ◽

10.1177/03000605211032429 ◽

2021 ◽

Vol 49 (7) ◽

pp. 030006052110324

Author(s):

Matjaž Horvat ◽

Marko Hazabent ◽

Marjan Sekej ◽

Milka Kljaić Dujić

Keyword(s):

Sigmoid Colon ◽

Bowel Obstruction ◽

Large Bowel ◽

Treatment Options ◽

Vascular Occlusion ◽

Abdominal Distension ◽

Large Bowel Obstruction ◽

Sigmoid Volvulus ◽

History Of

Sigmoid volvulus is an extremely rare cause of intestinal obstruction in pediatric patients. This condition occurs when a redundant sigmoid loop with a narrow mesenteric base of attachment to the posterior abdominal wall rotates around its mesenteric axis. This situation might result in vascular occlusion and large bowel obstruction. There are only a few predisposing factors of sigmoid volvulus, such as a long-term history of constipation or pseudo-obstruction with an excessive sigmoid colon. Underlying hypoganglionosis can also lead to large bowel obstruction. There have only been two reported cases of hypoganglionosis with sigmoid volvulus, and both were in adults. Sigmoid volvulus usually presents with abdominal pain, nausea, vomiting, constipation and abdominal distension, an absence of stool, or the presence of melenic stool in the rectum. Initial treatment options are non-surgical for stable patients, although surgical management might be necessary. If sigmoid volvulus is not recognized and resolved, it may lead to serious complications and death. Pediatric sigmoid volvulus is frequently the fulminant type, and therefore, a decision about treatment must be prompt. We present an unusual pediatric case of an extremely long sigmoid colon with hypoganglionosis, which twisted and caused obstruction. This condition was resolved with surgical resection.

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