intestinal resection
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2021 ◽  
pp. 12-18
Author(s):  
L. N. Kostyuchenko ◽  
A. E. Lychkova

The purpose is the tactics of nutritional rehabilitation after extensive intestinal resection. The metabolic characteristics of the short intestine syndrome and the consequences of combined fine-binding resections, as well as the adaptive and regenerative capabilities of the bowel, are presented. The optimal scheme of nutritional correction for the consequences of combined bowel resections is presented.Conclusion. To stimulate adaptive-regenerative processes in the intestine, it is advisable to use teduglutide (analogue of GLP-2); if ineffective, surgical rehabilitation can be recommended.


Author(s):  
I. V. Vakhlova ◽  
G. V. Fedotova ◽  
L. G. Boronina ◽  
Yu. N. Ibragimova

Introduction. The metabolic activity of the intestinal microbiota is an important indicator of the functioning of the digestive tract, one of the main functions of which is the absorption of nutrients.The aim of the study was to analyze the content of short chain fatty acids in feces and assess their relationship with the indicators of physical development in children 3 years of age.Materials and methods. A prospective cohort study was conducted in 89 children 3rd year of life. The 1st observation group included children of the I and II health groups, the children of the 2nd group underwent surgical treatment on the intestine in the first months of life, the children of the3rd group are with atopic dermatitis. FD assessment was carried out in accordance with WHO recommendations (2017) the spectrum of FGC in feces was determined by gas-liquid chromatography.Results. It was determined the features of the rates of FD in healthy children, children with a history of intestinal resection and children with atopy in relation to the indicators of metabolic activity of the intestinal microbiota. The percentile distribution of the values of FGC in feces and their comparative assessment in the observation groups are given.Discussion. The content of FGM in feces has differences depending on the health status of children of the 3rd year of life. Different level of FGC shows a close relationship with the indicators of FD. Conclusions. A decrease in growth rates (body length SD: from -1 to -2) was revealed at low values (<25%) of the amount of acids, with an increase in propionate (25%) in feces. Reduced nutrition (body weight SD: from -1 to -2) it was associated with low values of the sum of isoacids and AI(-) (<25%); by 3rd year of life, the risk of low nutrition decreased in 4 times with high values (75%) of the sum of acids in feces (OR=4.33[1.09-17.71]). The multidirectionality of the content of fecal matter in young children and their influence on the indicators of FD emphasizes the versatility of the functions of the intestinal microbiota, which has a local and systemic effect on the human body.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Keishi Yamaguchi ◽  
Takeru Abe ◽  
Kento Nakajima ◽  
Chikara Watanabe ◽  
Yusuke Kawamura ◽  
...  

AbstractAnastomotic leakage after intestinal resection is one of the most serious complications of surgical intervention for hollow viscus injury. Adequate vascular perfusion of the anastomotic site is essential to prevent anastomotic leakage. Near-infrared imaging using indocyanine green (NIR-ICG) is useful for the objective assessment of vascular perfusion. The aim of this study was to evaluate the association of NIR-ICG with intestinal and mesenteric injuries. This was a retrospective, single-center study of patients undergoing surgery for intestinal and mesenteric injuries. NIR-ICG was used to evaluate vascular perfusion. Postoperative complications were assessed between NIR-ICG and non-NIR-ICG groups.The use of NIR-ICG was associated with a lower incidence of Clavien-Dindo grade ≥ III complications with a statistical tendency (p = 0.076). When limited to patients that underwent intestinal resection, the use of NIR-ICG was significantly associated with a lower risk of perioperative complications (p = 0.009). The use of NIR-ICG tended to associate with the lower incidence of postoperative complications after intestinal and mesenteric trauma surgery. NIR-ICG was associated with a significantly lower risk of complications in patients undergoing intestinal resection. The NIR-ICG procedure is simple and quick and is expected to be useful for intestinal and mesenteric trauma.


2021 ◽  
Author(s):  
Hsiao-Tien Liu ◽  
Chia-Yu Lai ◽  
Jian-Jhou Liao ◽  
Yi-Ju Chen ◽  
Shao-Bin Cheng ◽  
...  

Abstract Background: Bowel gangrene represents a major fatal event in acute mesenteric infarction. Intestinal resection is inevitable in patients with peritonitis and bowel gangrene. This retrospective study aimed to elucidate the benefit of postoperative parenteral anticoagulant in patients with intestinal resection. Methods: Patients with acute mesenteric infarction and bowel gangrene were recruited retrospectively between January 2007 and December 2019. All patients underwent bowel resection. They were categorized into two groups: patients without immediate enoxaparin (group A) and those with immediate enoxaparin (group B). Both 30-day and 90-day mortalities were analyzed.Results: A total of 85 patients were included, with 29 patients in group A and 56 patients in group B. Patients in group B had both lower 30-day mortality (16.1%) and 90-day mortality (37.5%), compared to patients in group A (30-day mortality: 51.7%, p=0.001; 90-day mortality: 65.5%, p=0.021). In the 30-day mortality multivariate analysis, patients in group B had a better outcome (odds ratio = 0.087, 95% confidence interval between 0.017 and 0.446, p = 0.003). In the 90-day mortality multivariate analysis, patients in group B also had a better outcome (odds ratio = 0.252, 95% confidence interval between 0.065 and 0.983, p = 0.047).Conclusion: Immediate postoperative parenteral anticoagulant improves short-term prognosis in patients with acute mesenteric infarction and intestinal resection.Trial registration: This research was retrospectively approved by Institutional Review Board (IRB) I&II of Taichung Veterans General Hospital (TCVGH-IRB No.CE21256B) on July 28th, 2021. Informed consent waiver was also approved by IRB I&II of Taichung Veterans General Hospital. Declaration of Helsinki and ICH-GCP guidelines were followed during this study.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bailin Chen ◽  
Jian Cao ◽  
Chengwei Yan ◽  
Chao Zheng ◽  
Jingyu Chen ◽  
...  

Abstract Background The most critical concern for the management of childhood intussusception is bowel resection due to intestinal ischemia and necrosis. The early prediction of this problem is of great importance. We investigated the value of various combinations of inflammatory factors to predict intestinal necrosis and resection. Methods We retrospectively reviewed the medical records of pediatric patients with intussusception who underwent surgical management. During the research period, 47 patients who underwent intestinal resection due to intestinal necrosis and 68 patients who did not undergo intestinal resection were enrolled. We evaluated the diagnostic value of various combinations of inflammatory markers from preoperative laboratory analyses using the receiver operating characteristic (ROC) method. Results In the current cohort, 115 patients underwent operations for intussusception; among them, 47 patients (40.9%) underwent intestinal resections. In the patients with intestinal resection, the neutrophil count(p = 0.013), CRP level(p = 0.002), platelet–lymphocyte ratio (PLR, p = 0.008), NLR (neutrophil–lymphocyte ratio, p = 0.026), and LCR (lymphocyte–CRP ratio, p < 0.001) values were significantly higher than those in the patients without any resection. The receiver operating characteristic (ROC) analysis results showed that the combination of lymphocytic count along with C-reactive protein levels (LCR) demonstrated the highest correlation with intestinal resection due to intussusception compared with other parameters in the patients, with a sensitivity of 0.82 (0.73–0.86) and specificity of 0.80 (0.57–0.94) for the diagnosis of strangulation. Conclusion The preoperative LCR level is a useful marker to predict the need for intestinal resection due to intestinal necrosis in patients with intussusception.


2021 ◽  
Author(s):  
Ylva Hedberg-Alm ◽  
Eva Tydén ◽  
Lena-Mari Tamminen ◽  
Lisa Lindström ◽  
Karin Anlén ◽  
...  

Abstract Background: Peritonitis in horses secondary to non-strangulating infarction (NSII) has a grave prognosis, even after intestinal resection. In contrast, horses with idiopathic peritonitis respond well to medical treatment. Affected horses in both cases often show signs of both colic and systemic inflammation, but early diagnosis is crucial for optimal treatment and an accurate prognosis. One cause of NSII is thrombus formation secondary to Strongylus vulgaris larval migration. There has been a documented increase in S. vulgaris prevalence in Sweden since the implementation of selective anthelmintic treatment in 2007, which subsequently could result in a rise in NSII cases. In a retrospective clinical study, medical records from cases diagnosed with NSII or idiopathic peritonitis from three equine referral hospitals in Sweden during 2017-2020 were reviewed. Information including demographic data, relevant medical history, and clinical- and laboratory parameters were obtained from patient records. To facilitate the differentiation between cases of idiopathic peritonitis and cases with confirmed NSII, the aim of the study was to compare clinical and laboratory parameters, clinical progression and initial response to antimicrobial treatment as well as survival-rates.Results: Horses with NSII (n = 20) were significantly more likely to present during the winter months with a poorer response to medical treatment within 48 hours. Cases of idiopathic peritonitis (n = 115) had a 99.1 % survival rate with medical treatment. In comparison, all confirmed NSII cases were non-responsive to antimicrobial treatment and had a low survival rate (25%) with surgical treatment. Specific rectal findings and peripheral blood neutropenia were strongly associated with NSII. Conclusions: In Sweden, idiopathic peritonitis cases still predominate over S. vulgaris associated NSII cases and have an excellent survival rate with antimicrobial treatment. However, horses presenting with septic peritonitis during the winter months with a palpable rectal mass and continuing fever and colic signs beyond 48 hours of medical treatment are likely to suffer from NSII and should be considered for abdominal surgery.


Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1660
Author(s):  
Tasuku Kato ◽  
Yasuhisa Nakano ◽  
Fumiko Yamane ◽  
Ryuichi Ohta ◽  
Chiaki Sano

Short bowel syndrome (SBS) causes malabsorption due to extensive intestinal resection. While intestinal function declines with age, little is known about the relationship between intestinal failure and ageing. For the first time in Japan, we report a case of de-adaptation of SBS thought to be due to ageing, in a 93-year-old woman who presented with electrolyte imbalance and malnutrition. She had undergone five surgical resections of the small intestine over the past 20 years. She had developed SBS once due to multiple surgeries, but due to compensatory function, the symptoms had abated. However, due to decreased intestinal function caused by ageing, it worsened and symptoms reappeared. A literature search for the period January 1990 to May 2021 in Ichushi a major journal in Japan, found that de-adaptation of SBS occurred in 23 previous cases, of which we were able to confirm the details in 17 cases, with no case reports on “de-adaptation of SBS”, demonstrating that the concept of “intestinal failure” has only recently begun to be used in routine practice. Therefore, we stress the importance of re-emphasizing the concept of ”intestinal failure” in everyday practice, as well as other organ-related conditions such as cardiac or renal failure, as this may lead to a better understanding of the pathogenesis of malnutrition and diarrhoea in elderly patients.


Author(s):  
Luiz Carlos Benjamin do Carmo ◽  
Fábio Guilherme Campos ◽  
Renato Barreto ◽  
Diogo Fontes ◽  
Thiago Ibiapina ◽  
...  

Abstract Background Multiple small-bowel diverticulosis comprises a rare entity with probable underestimated incidence, and that may be the reason why it is sometimes overlooked when managing cases with peritonitis. Case report In the present paper, we report the case of a 76-year-old male presenting abdominal pain and fever in an acute setting. Computed tomography (CT) scans revealed jejunal thickening and numerous images of saccular addition that were interpreted as jejunoileal diverticulitis. After an initial period of clinical treatment, surgical management was indicated based on a worsening clinical picture and the presence of an extraluminal focus of gas detected in a subsequent CT scan. Through a laparoscopic approach, multiple small-bowel diverticula and a tamponade perforation were found. A segmental intestinal resection was performed, and the patient was discharged after a ten days. Conclusions Multiple jejunal diverticulosis is a rare condition that should be remembered in the setting of an acute abdomen. As it prevails among older patients, early diagnosis with radiological aid is crucial to establish the most adequate management, including intestinal resection, if necessary.


2021 ◽  
Vol 1 (1) ◽  
pp. 37-41
Author(s):  
Ahmed H. Al-Salem ◽  
Moustafa Hamchou ◽  
Hillal Matta ◽  
Adnan Swid ◽  
Bahjat Sahari ◽  
...  

Ingestion of magnets is becoming a common problem among children and teens and are known to be associated with serious complications that result from pressure necrosis and bowel perforation. We report a series of eight children with multiple magnets ingestion that resulted in complications including small bowel perforation and intestinal obstruction necessitating an emergency laparotomy and intestinal resection. The aim of this report is to raise awareness of the complications associated with magnet ingestion in children. The literature on the subject is also reviewed and early surgical intervention is recommended for multiple swallowed magnets. The role of laparoscopy in this regard is also stressed.


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