Subacute small bowel obstruction or chronic large bowel obstruction

BMJ ◽  
2021 ◽  
pp. n1765
Author(s):  
Marc Winslet ◽  
Kevin Barraclough ◽  
Gregor Campbell Hewson
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Large Bowel Obstruction

scholarly journals Intravenous Contrast Agent in Abdominal CT: Is It Really Needed to Identify the Cause of Bowel Obstruction? Proof of Concept

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Federica Vernuccio ◽  
Dario Picone ◽  
Gregorio Scerrino ◽  
Massimo Midiri ◽  
Giuseppe Lo Re ◽  
...  
Keyword(s):  
Small Bowel ◽  
Contrast Agent ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Large Bowel Obstruction ◽  
Intravenous Contrast ◽  
Unenhanced Ct ◽  
Enhanced Ct ◽  
Intravenous Contrast Agent

Background. To compare sensitivity of unenhanced computed tomography (CT) and contrast-enhanced CT for the identification of the etiology of bowel obstruction. Materials and Methods. We retrospectively evaluated abdominal CT scans of patients operated for bowel obstruction from March 2013 to October 2017. Two radiologists evaluated CT scans before and after contrast agent in two reading sessions. Then, we calculated sensitivity of CT in the diagnosis of bowel obstruction and determined in which cases the etiology of bowel obstruction was detected on both unenhanced and enhanced CT or on enhanced CT only. The reference standard was defined as the final diagnosis obtained after surgery. Results. Eighteen patients (mean age 72±15 years, age range 37-88 years) were included in the study. Sensitivity of unenhanced CT and enhanced CT was not significantly different in either small bowel obstruction (64%, 7/11 patients vs. 73%, 8/11 patients; P=0.6547) or large bowel obstruction (71%, 5/7 patients vs. 100%, 7/7 patients; P=0.1410). Adhesions were identified on unenhanced CT as the etiology of small bowel obstruction in 80% (4/5) of patients. Tumors were identified on unenhanced CT as the etiology of large bowel obstruction in 67% (4/6) of patients. Conclusion. In the diagnosis of small bowel obstruction due to adhesions with normal bowel wall thickening and when a neoplasm is identified as the etiology of large bowel obstruction on unenhanced CT, an intravenous contrast agent may be avoided for the identification of the etiology. In remaining cases, contrast agent is still recommended.

Ileus and Obstruction in the Surgical Critical Care Patient

2017 ◽  
Author(s):  
Eric Benoit ◽  
Charles A Adams Jr
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Critically Ill ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Bacterial Overgrowth ◽  
Large Bowel Obstruction ◽  
Surgical Patient ◽  
Gastrointestinal Dysfunction ◽  
Surgical Critical Care

Gastrointestinal dysfunction is a common occurrence in the critically ill surgical patient as both a contributor to disease progression and a consequence of critical illness. Failure of motility may ultimately progress to obstruction, either functional (e.g., paralytic ileus) or mechanical (e.g., small bowel obstruction). Obstruction leads to bowel distention, fluid sequestration in the lumen and wall of the bowel, alterations in mucosal integrity, and bacterial overgrowth, which results in not only local bowel ischemia but also distant organ damage due to the release of inflammatory cytokines. Although postoperative ileus is a common condition, in the critically ill patient, it may signify a serious complication such as anastomotic leak or sepsis; therefore, management is directed toward identification and treatment of the underlying cause. Regarding small bowel obstruction (SBO), management hinges on whether or not the bowel is strangulated, and the need for operation should be addressed at every step of the evaluation. Although most patients are successfully treated without operation, SBO is a surgical disease, a fact underscored by the improved outcomes seen in patients admitted to a surgical service. Large bowel obstruction is a surgical emergency that requires prompt decompression either by colonoscopy or surgery. Regardless of the etiology of gastrointestinal dysfunction, emergency surgery is required in patients with signs of bowel strangulation or perforation such as tachycardia, peritonitis, fever, or leukocytosis. Key words: acute colonic pseudo-obstruction, adhesive small bowel disease, ileus, large bowel obstruction, Ogilvie syndrome, small bowel obstruction bowel perforation, volvulus

scholarly journals Diagnosis and treatment of acute bowel obstruction

2013 ◽  
Vol 94 (3) ◽  
pp. 377-381
Author(s):  
A M Khadjibaev ◽  
N A Khadjimukhamedova ◽  
F A Khadjibaev
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Bowel Resection ◽  
Primary Anastomosis ◽  
Local Treatment ◽  
Small Bowel Resection ◽  
Large Bowel Obstruction ◽  
Segmental Resection ◽  
Diagnosis And Treatment

Aim. To improve treatment outcomes in patients with acute bowel obstruction. Methods. 1479 patients with bowel obstruction (75.7% - small bowel obstruction, 24.3% - large bowel obstruction) were examined. Patients were treated according to the local treatment protocol, 1003 (68%) patients underwent surgery. Results. The following procedures were performed at the stage of bowel obstruction diagnosis and treatment: conventional adhesiolysis was performed in 425 cases, laparoscopic adhesiolysis - in 425 cases, small bowel resection with further anastomosis - in 151 cases, small bowel resection with ileostomy - in 15 cases, phytobezoar fragmenting - in 56 cases, enterotomy and phytobezoar removal - in 2 cases. In patients with large bowel obstruction the following procedures were performed: large bowel segmental resection with further anastomosis - in 38 cases, large bowel segmental resection with colostomy - in 38 cases, large bowel partial resection with colostomy - in 54 cases, right hemicolectomy with primary anastomosis - in 43 cases, left hemicolectomy with primary anastomosis - in 58 cases, manual intussusception reduction - in 65 cases, side anastomosis - in 31 cases. In 69 cases of bowel obstruction primary anastomosis was performed using the metal ring frame. Conclusion. To reduce the rate of complications, the need for the surgery should be diagnosed as soon as possible, coagulopathies should be compensated, and surgery tactics should be defined, including the primary anastomosis formation.

Enterolith ileus and jejunal diverticulitis from jejunal diverticulosis: the complications of a rare gastrointestinal entity

2021 ◽  
Vol 14 (6) ◽  
pp. e243252
Author(s):  
Blake Anthony Sykes ◽  
Chitrakanti Raj Kapadia
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Rare Entity ◽  
Jejunal Diverticulosis ◽  
Bowel Content ◽  
Jejunal Diverticulitis

Small bowel diverticulosis is rare. False diverticula form in the jejunum, and less commonly, the ileum. As with their large bowel counterparts, these diverticula provide a pocket for stasis of bowel content, leading to the formation of enteroliths. This case report highlights two complications from jejunal diverticulosis: jejunal diverticulitis and a small bowel obstruction as a result of enterolithiasis; the latter being a rare entity which should be a differential diagnosis for any individual presenting with gastrointestinal obstructive symptoms and radiological evidence of small bowel diverticulosis.

scholarly journals Study of clinical spectrum and management of acute intestinal obstruction

2018 ◽  
Vol 5 (4) ◽  
pp. 1310
Author(s):  
N. K. Jaiswal ◽  
Sandeep Shekhar ◽  
Pushkar Ranade
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Signs And Symptoms ◽  
Large Bowel Obstruction ◽  
Acute Intestinal Obstruction ◽  
Medical College ◽  
Tertiary Centre

Background: Acute intestinal obstruction is one of the major surgical emergencies. Intestinal obstruction is defined as partial or complete interference with forward flow of small or large intestinal contents. Intestinal obstruction of either small or large bowel continues to be a major cause of morbidity and mortality. Study aims to find the aetiology, diagnosis and management of acute intestinal obstruction.Methods: A total of 135 patients of acute intestinal obstruction was studied from November 2013 to October 2015 in government medical college, Nagpur. Study was done in patients in OPD of this tertiary centre. Inclusion criteria being patients coming to the hospital with features suggestive and further confirmed of acute intestinal obstruction. Patients included were in, age group of 18 years to 80 years giving written informed consent. Patient of pseudo obstruction were excluded from the study.Results: A total of 135 patients, presented with acute intestinal obstruction during the period of the study. Mean patient age was 45.87 years with peak incidence in those aged 21-30years. The foremost signs and symptoms were constipation (85.93%) and abdominal pain (91.11%). Adhesions and bands (61.9%) was the leading causes of intestinal obstruction.Conclusions: Present study concluded that small bowel obstruction is more common than large bowel obstruction. Abdominal pain, constipation and distension are the most common symptoms, while increased bowel sounds, tachycardia and tenderness is most common sign. Post-operative adhesion in small bowel and malignancy in large bowel is major cause of acute intestinal obstruction.

Large-bowel disease presenting as small-bowel obstruction is associated with a poor prognosis

2016 ◽  
Vol 34 (3) ◽  
pp. 477-479 ◽  
Author(s):  
Jessica L. Weaver ◽  
Rebecca E. Barnett ◽  
Danielle E. Patterson ◽  
Vikram G. Ramjee ◽  
Eric Riedinger ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Bowel Disease ◽  
Large Bowel ◽  
Poor Prognosis

scholarly journals A curious case of cololithiasis

2018 ◽  
Vol 100 (7) ◽  
pp. e188-e190 ◽  
Author(s):  
L Creedon ◽  
H Boyd-Carson ◽  
J Lund
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Bowel Obstruction ◽  
Bowel Preparation ◽  
Large Bowel ◽  
Gallstone Ileus ◽  
Expectant Management ◽  
Large Bowel Obstruction ◽  
Uneventful Recovery ◽  
Rectosigmoid Junction

Gallstone ileus is an uncommon cause of bowel obstruction that involves cholecystoenteric fistulation and resultant passage of gallstones into the bowel. In the vast majority of cases, the fistula forms between the gallbladder and duodenum leading to small bowel obstruction. We report a case of cholecystocolic fistulation and subsequent large-bowel obstruction in a 75-year-old woman who presented acutely after taking a bowel preparation for an outpatient colonoscopy during the course of an investigation of anaemia and nonspecific abdominal pain. Preintervention imaging revealed a giant gallstone at the rectosigmoid junction, in the presence of a cholecystocolic fistula, and subsequent large bowel obstruction. After a failed period of expectant management, laparotomy and Hartmann’s procedure were performed and the patient made an uneventful recovery.

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