scholarly journals HOSPITAL EPIDEMIOLOGY OF ABDOMINAL ADHESIONS

2016 ◽  
Vol 1 (4) ◽  
pp. 115-118 ◽  
Author(s):  
Аюшинова ◽  
Natalya Ayushinova ◽  
Шурыгин ◽  
Mikhail Shurygin ◽  
Шурыгина ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Clinical Symptoms ◽  
Abdominal Cavity ◽  
Abdominal Adhesions ◽  
Hospital Epidemiology ◽  
Surgical Interventions ◽  
Adhesive Intestinal Obstruction ◽  
Intestinal Fistulas ◽  
Regional Hospitals ◽  
Methods Of Treatment

The purpose of the research was to establish main causes of development and outcomes of adhesive obstruction.We analyzed the outcomes of treatment of 154 patients with acute intestinal obstruction. The following data were taken into consideration: age, gender, surgeries in past medical history, terms of adhesions manifestations, clinical symptoms, findings of additional examinations, methods of treatment, outcome. It has been established, that the most frequent causes of adhesions were appendectomy (23%), stomach operations (21 %) and gynecological interventions (14 %). After surgeries performed in conditions of regional hospitals, adhesions developed after appendectomy, gynecological operations and interventions on the intestine. In patients operated in city hospitals intestinal obstruction more often occurred after extensive operations on the stomach, appendix, and after gynecological interventions. Urgent surgical interventions more often led to adhesive process in the abdominal cavity (63 %). Mortality made 5.8 %. Causes of death were intestinal fistulas and abdominal sepsis.Thus, acute adhesive intestinal obstruction as an extreme form of abdominal adhesions continues to be an urgent medical issue.

scholarly journals Adhesive disease of the abdominal cavity

2017 ◽  
Vol 10 (4) ◽  
pp. 320-326 ◽  
Author(s):  
Alexandr Alexeevich Andreev ◽  
Anton Petrovich Ostroushko ◽  
Elena Sergeevna Sotnikova ◽  
Daria Vladimirovna Kiryanova ◽  
Vladislav Nikolaevich Britikov
Keyword(s):  
Conservative Treatment ◽  
Intestinal Obstruction ◽  
Body Position ◽  
Intestinal Anastomosis ◽  
Abdominal Cavity ◽  
Adhesion Formation ◽  
Protective Film ◽  
Abdominal Adhesions ◽  
Surgical Interventions ◽  
Protein Components

After operations on the abdominal adhesions occur in 80-90% of cases, adhesive disease develops in 12-64% of cases. First about the causes of adhesions said George Punter in 1793. For the first time in the Russian literature on intraperitoneal adhesions mentioned V.P. Dobrovolsky in 1838. According to modern notions, adhesive disease is a separate nosological form, characterized by the formation of intra-abdominal adhesions, as a rule, manifested by recurrent episodes of intestinal obstruction or pain. The basis for the development of peritoneal commissures in abdominal cavity are a complex, diverse violations of the functions of various body systems. Trigger in the development of adhesion formation in abdominal cavity considered: mechanical, physical, infectious, implant, chemical factors and congenital anomalies (bands of lane, membranes of Jackson and others). As a result of inflammation of the peritoneum dystrophic process, accompanied by desquamation of the mesothelium and other connective tissue layers of the peritoneum, there is an allocation of exudate, coagulation of protein components and formation of fibrinous adhesions, which under normal fibrinolytic activity within 24-72 hours lysed. There are four degrees of prevalence of adhesions: grade I – local adhesions, occupying not more than 1/3 of one floor; II degree – additionally determined by single spikes in other areas. III and IV degree – adhesions, occupying 1/3 and 2/3 of the abdominal cavity, respectively. The clinical picture of adhesive disease is expressed aching pain in the abdomen, changing its character with the change of body position; periodic bloating, unstable chair; vomiting during exercise or after violation of the diet, the phenomena of complete or partial adhesive intestinal obstruction. Diagnostic informativeness of traditional x-ray methods is only 50-60%. The most informative is the use of contrast enterography and ultrasound examination of the abdomen with a directed study of problem areas of the abdomen. Prevention of adhesions is an important problem of practical surgery. Methods of preventing the formation of adhesions are the following: reduction of abdominal trauma, reducing inflammation in the area of operations, reducing the likelihood of deposition of fibrin in the free abdominal cavity, the suppression of postoperative paresis of the intestine, delimitation of the damaged serosal surfaces and interfere with adhesion by applying a protective film on the mesothelium. Application drugs does not negate the careful attitude to the tissues and accurate surgical interventions. Conservative treatment includes: electrophoresis lidazy, hydrocortisone, application of paraffin, ozokerite on the anterior abdominal wall, injection antispasmodics, nasogastric drainage, staging of hypertension and cleansing enemas and others. Indications for operative intervention are: absence of effect of conservative treatment, the deterioration of the patient, the symptoms of acute intestinal obstruction. The following types of surgery: enteroclysis, the imposition of intestinal anastomosis with or without bowel resection laparoscopic lysis of adhesions, entropicalia.

scholarly journals Adhesive intestinal obstruction as a complication of Meckel’s diverticulum in children

2021 ◽  
pp. 107-111
Author(s):  
S.O. Sokolnyk ◽  
◽  
O.B. Bodnar ◽  
O.F. Marchuk ◽  
L.I. Vatamanesku ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Clinical Symptoms ◽  
Rare Complication ◽  
Meckel’S Diverticulum ◽  
Abdominal Cavity ◽  
Key Words Children ◽  
Meckel's Diverticulum ◽  
Intestinal Bleeding ◽  
Intestinal Tube ◽  
Adhesive Intestinal Obstruction

Meckel’s diverticulum (DM) is a formation of the ileum caused by incomplete obliteration of the omphalomesenteric duct in the developing embryo. This is one of the most common anomalies of the digestive tract in children. Most DM develops completely asymptomatically. Clinical symptoms develop in only 16% of cases, and 50–60% of them are children under 10 years, an average of 2.5 years of age. The severity of clinical symptoms in DM is associated with the development of complications: intestinal bleeding, intestinal obstruction (intussusception, strangulation intestinal obstruction), diverticulitis with perforation and peritonitis, etc. The article presents a clinical case of adhesive intestinal obstruction in an 8-year-old, which occurred after DM in the anamnesis. As the adhesive intestinal obstruction is an extremely rare complication of DM in children, the presence of patients with acute surgical pathology of the abdominal cavity requires pediatric surgeons to clearly understand the occurrence of such complications in the perspective of the development of intestinal tube defect – DM and the need for the immediate radical treatment tactics in the event of this problem. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: children, Meckel’s diverticulum, complications, adhesive intestinal obstruction.

Treatment of adhesive intestinal obstruction

1980 ◽  
Vol 61 (5) ◽  
pp. 53-54
Author(s):  
I. I. Kluev ◽  
V. S. Belikov ◽  
V. I. Kluev
Keyword(s):  
Intestinal Obstruction ◽  
Abdominal Cavity ◽  
Adhesive Intestinal Obstruction ◽  
Surgical Clinic

Of the 896 patients admitted to the surgical clinic of the Mordovian University in 1967-1976. for intestinal obstruction, 507 (56.6%) had adhesive intestinal obstruction or adhesive disease of the abdominal cavity. Adhesive disease of the abdominal cavity can occur at any age, but more often - from 20 to 50 years. The time elapsed from the operation to the onset of symptoms, adhesions (pain attacks), in 52 patients did not exceed 1 month, in 80 it was from 2 to 6 months, in 186 - from 6 months to 1 year, in 142 - from 1 year up to 5 years and in 47 - from 5 to 10 years or more.

scholarly journals The Point-Rating Scale for Determining Treatment Tactics in Patients With Adhesive Small Bowel Obstruction

2021 ◽  
Vol 10 (2) ◽  
pp. 303-308
Author(s):  
B. V. Sigua ◽  
V. P. Zemlyanoy ◽  
B. P. Filenko ◽  
P. A. Kotkov ◽  
D. Kh. Kalandarova ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Conservative Therapy ◽  
Rating Scale ◽  
Negative Impact ◽  
Morphological Changes ◽  
Abdominal Cavity ◽  
Adhesive Small Bowel Obstruction ◽  
Point Rating Scale ◽  
Adhesive Intestinal Obstruction ◽  
Therapy Success

Relevance. The most practiced method of treating patients with acute intestinal obstruction - urgent surgical intervention - does not guarantee remission, contributing to the progression of morphological changes in the abdominal cavity. From this perspective, a shift in emphasis towards the planned surgical treatment of patients with adhesive disease with the use of the existing anti-adhesive methods after conservative resolution of the intestinal passage disorders looks like a promising direction.Aim of the study. Improving the results of patients with acute adhesive intestinal obstruction treatment by developing a point-rating scale that allows to highlight groups of patients who are prone to conservative resolution of intestinal passage disorders episode, and, thereby, reduces the proportion of urgent interventions.Material and methods. The analysis of the 125 patients treatment results (retrospective group) admitted with symptoms of acute adhesive intestinal obstruction was carried out. On this basis, the point-rating scale was developed including a number of factors that have certain value in terms of predicting the probability of conservative therapy success. Subsequently the developed scale was applied in 170 patients (prospective group) as part of treatment tactics implementation aimed at maximally conservative resolution of adhesive intestinal obstruction without negative effect on the immediate results of patients operated in later periods.Results. The developed point-rating scale made it possible to reduce the frequency of urgent interventions among patients with signs of acute adhesive intestinal obstruction (from 79.2% to 57.6%) due to longer conservative measures — 18.1±17.2 and 11,2±8.7 hours in prospective and retrospective groups, respectively). There was no negative impact on the frequency of resection interventions (12.2 and 16.1% in the prospective and retrospective groups) as well as postoperative complications and overall mortality.Conclusions. The developed point-assessment scale made it possible to stratify patients in accordance with the probability of conservative therapy success and to justify its continuation for more than 12 hours in low-risk patients. The obtained results allow us to recommend the proposed scale for use in clinical practice. 

scholarly journals RESULTS OF SURGICAL TREATMENT OF NON-PARASITIC SPLENIC CYSTS IN CHILDREN

2018 ◽  
Vol 22 (1) ◽  
pp. 32-35
Author(s):  
A. V. Myzin ◽  
Vasily G. Kuleshov ◽  
A. E. Stepanov ◽  
N. V. Gerasimova ◽  
K. Yu. Ashmanov
Keyword(s):  
Surgical Treatment ◽  
High Efficiency ◽  
Clinical Symptoms ◽  
Abdominal Cavity ◽  
Long Term Results ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Splenic Cysts ◽  
Good Cosmetic

Introduction. Currently, there are different views on the treatment of non-parasitic spleen cysts in children. The choice of method of treatment is under discussion. The aim of our study was to evaluate and analyze the immediate and long-term results of surgical interventions performed on nonparasitic spleen cysts in children. Material and methods. There are presented results of surgical treatment of the 21 patient, who was on treatment at the Department of Abdominal Surgery of the Russian Children Clinical Hospital over the period from 2013 to 2016. Patients were examined by means of ultrasound of the abdominal cavity, CT, MRI. All patients have been operated. 22 surgical interventions were performed by using laparoscopic access, out of which 2 partial resections of the spleen, 1 splenectomy, 19 fenestrations of spleen cysts.Results. During the course of the operation and in the immediate postoperative period there were no complications. Patients were observed for the period of from 1 year to 3 years. Good results of treatment were obtained in 20 (95.2%) children. In a long-term period a relapse occurred in the one patient one year after the operation. The patient was reoperated, splenectomy was performed. Conclusion. The surgical treatment of spleen cysts is the basic one. It is indicated for cysts sized larger than 5 cm and cysts with clinical symptoms. Minimally invasive interventions in children are optimal because of their low traumatism and good cosmetic effect. Our study showed a high efficiency of laparoscopic operations in children suffered from non-parasitic spleen cysts with good long-term results.

scholarly journals BIOMATERIALS BASED ON CHITOSAN AND ITS DERIVATIVES TO PREVENT ADHESION FORMATION

2021 ◽  
Vol 26 ◽  
pp. 11-22
Author(s):  
Mariya Konovalova ◽  
◽  
Daria Tsaregorodtseva ◽  
Elena Svirshchevskaya ◽  
Keyword(s):  
Quality Of Life ◽  
Intestinal Obstruction ◽  
Abdominal Cavity ◽  
Adhesion Formation ◽  
Reproductive Function ◽  
Postoperative Adhesions ◽  
Surgical Interventions ◽  
Adhesion Process ◽  
Mechanisms Of Adhesion

An increase in the number and volume of surgical interventions leads to an increase in the frequency of postoperative adhesions. The development of the adhesion process in the abdominal cavity causes pain, a decrease in the quality of life of patients, a violation of the reproductive function of women as well as acute adhesion intestinal obstruction. Recently, polymer biomaterials, including those based on chitosan, have been widely used for the prevention of adhesions. Due to their biocompatibility and biodegradation ability, they do not require repeated operations to extract the material. It is believed that these materials act as barriers, physically separating the damaged surfaces. The molecular mechanism of their action is still poorly understood. In this review, the main mechanisms of adhesion formation, as well as ways to prevent them with the help of materials based on chitosan and its derivatives, are discussed.

scholarly journals NEW PROSPECTS OF DIAGNOSIS IN EMERGENCY ABDOMINAL SURGERY

2021 ◽  
pp. 47-51
Author(s):  
A. I. Shurma ◽  
F. V. Grinchuk ◽  
A. V. Motric
Keyword(s):  
Peptic Ulcer ◽  
Acute Appendicitis ◽  
Intestinal Obstruction ◽  
Blood Plasma ◽  
Optical Density ◽  
Abdominal Cavity ◽  
Venous Blood ◽  
Underlying Disease ◽  
Colon Perforation ◽  
Adhesive Intestinal Obstruction

Summary. Aim. Search for new methods for diagnosing acute surgical pathology of the abdominal cavity (ASPAC). Materials and methods. 39 patients: liver abscess — 4, acute appendicitis, periapendicular abscess — 3, acute appendicitis, perito-nitis — 5, acute phlegmonous appendicitis — 7, acute phlegmonous cholecystitis — 4, colon perforation, peritonitis — 3 , acute uncomplicated adhesive intestinal obstruction — 4, uncomplicated peptic ulcer — 4. Measured the optical density of venous blood plasma on a spectrophotometer SF-4A. The control was given to 8 patients (adhesive intestinal obstruction, uncomplicated peptic ulcer disease). Results and discussion. A number of maxima of the values of the optical density of the plasma at wavelengths λ = 3.1, 3.5, 4.3, 6.1, 6.7, 9, 17.5 micrometers were revealed. Indicators differed depending on the type of underlying disease and complications. For analysis and comparison, patients were divided into groups: abscesses, peritonitis, destructive pathology without peritonitis (appendicitis, cholecystitis) and control. At wavelengths λ = 3.1, 6.1, 6.7, 9, 17.5 micrometers, the optical density in patients with no destructive pathology is significantly lower than in patients with such pathology. In addition, the indicators differ in the presence of peritonitis, abscesses and uncomplicated destructive pathology. Conclusions. In the presence of acute surgical diseases of the abdominal cavity in patients, the specific maxima of the optical density of venous blood plasma in the infrared region at wavelengths λ = 3.1, 3.5, 4.3, 6.1, 6.7, 9, 17 , 5 micrometers. Changes in the parameters of optical density differ, depending on the characteristics of the underlying disease and complications and have common patterns in the perforation of hollow organs, abscesses, peritonitis, destructive uncomplicated diseases. Determination of optical density is a promising area for improving the diagnosis of ASPAC.

scholarly journals Intestinal Obstruction: An Overview of Aetiology, Evaluation and Management

2019 ◽  
Vol 17 (2) ◽  
pp. 89-95
Author(s):  
ABM Khurshid Alam ◽  
Kazi Lsrat Jahan ◽  
Mohammad Ali
Keyword(s):  
Intestinal Obstruction ◽  
Clinical Symptoms ◽  
Abdominal Distension ◽  
Initial Study ◽  
Abdominal Adhesions ◽  
Radiologic Imaging ◽  
Vascular Compromise ◽  
Intestinal Decompression ◽  
Bowel Rest ◽  
Bowel Decompression

Intestinal obstruction occurs when there is an interruption in the forward flow of intestinal contents. This interruption can occur at any point along the length of the gastrointestinal tract, and clinical symptoms often depend on the level of obstruction. Intestinal obstruction is most commonly caused by intra-abdominal adhesions, malignancy, or intestinal herniation. The clinical presentation generally includes colicky abdominal pain, vomiting, abdominal distension and constipation. Radiologic imaging can confirm the diagnosis. Although radiography is often the initial study, non-contrast computed tomography is recommended if the index of suspicion is high or if suspicion persists despite negative radiography. Management of uncomplicated obstructions includes fluid resuscitation with correction of metabolic derangements, intestinal decompression, and bowel rest. Evidence of vascular compromise or perforation, or failure to resolve with adequate bowel decompression is an indication for surgical intervention. Journal of Surgical Sciences (2013) Vol. 17 (2): 89-95

scholarly journals IMPROVEMENT OF METHODS OF DIAGNOSTICS AND TREATMENT OF ACUTE DISEASES OF ORGANS OF ABDOMINAL CAVITY IN CHILDREN

2019 ◽  
Vol 23 (1) ◽  
pp. 40-43
Author(s):  
Sherali R. Sultonov ◽  
M. F. Abdulloev ◽  
S. S. Rasulov ◽  
R. Sh. Akhmedov ◽  
D. M. Kurbanov ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Intestinal Obstruction ◽  
Acute Cholecystitis ◽  
Diagnostic Laparoscopy ◽  
Abdominal Cavity ◽  
Meckel Diverticulum ◽  
Pelvic Organs ◽  
Adhesive Intestinal Obstruction ◽  
Positive Results

There are presented results of therapeutic-diagnostic laparoscopy in 317 children with various pathologies of the abdominal cavity organs, aged from 2 to 15 years. Among patients there were 163 children with acute appendicitis and its complications, 68 girls with acute pathologies of pelvic organs, 39 cases with the acute adhesive intestinal obstruction, 14 - with intussusception, 11 patients with pathology of Meckel diverticulum, 5 - with acute cholecystitis, 5 - with cystic doubling intestine - and 6 - with intestinal mesentery tumor. Diagnostic laparoscopy also revealed acute mesadenitis in 4 cases, and urolithiasis was diagnosed in 2 cases. In the treatment and diagnostic laparoscopy, the switch to the conversion was noted in 19 (5.9%) cases. In 298 (94.1%) cases, the treatment and diagnostic laparoscopy was effective and in these patients positive results were noted

scholarly journals TREATMENT OF ACUTE ADHESIVE INTESTINAL OBSTRUCTION WITH MINI-INVASIVE METHODS

InterConf ◽  
2021 ◽  
pp. 768-773
Author(s):  
Sanjar Ruziboev ◽  
Gennady Khaydarov ◽  
Abdurakhim Avazov ◽  
Masrur Mukhammadiev
Keyword(s):  
Surgical Treatment ◽  
Intestinal Obstruction ◽  
Intestinal Motility ◽  
Abdominal Cavity ◽  
Intestinal Resection ◽  
Intestinal Fistula ◽  
Results Of Treatment ◽  
Adhesive Intestinal Obstruction ◽  
Early Restoration ◽  
Length Of Hospitalization

The authors studied the results of treatment of patients with adhesive disease of the abdominal cavity, determined the frequency of relapses of adhesive intestinal obstruction and studied the possibility of laparoscopic adhesiolysis in the surgical treatment of acute adhesive intestinal obstruction. A total of 987 patients with AIN were operated on: of whichlaparotomy adheziolysis - 539, intestinal resection laparotomy with interintestinal anastomosis-246, intestinal resection laparotomy with excretion of intestinal fistula-88, laparoscopy adhesiolysis-114. The use of laparoscopic adhesiolysispromotes to the early restoration of intestinal motility within 24-48 hours, reduces the frequency of relapses of adhesive disease, and reduces the length of hospitalization on average to 6.8 days.

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