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 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 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 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.

scholarly journals Early diagnostics of acute honestious intestinal incapability with help of X-ray tomography

2018 ◽  
pp. 55-59
Author(s):  
I. F. Sufiyarov ◽  
F. F. Mufazalov ◽  
G. R. Yamalova
Keyword(s):  
Intestinal Obstruction ◽  
Surgical Intervention ◽  
Abdominal Cavity ◽  
Intestinal Wall ◽  
Peritoneal Adhesion ◽  
Peritoneal Disease ◽  
X Ray ◽  
Pearson Criterion ◽  
X Ray Computed ◽  
Adhesive Intestinal Obstruction

The most important problem determining the indications for surgical treatment of peritoneal adhesion is associated with the uncertainty of the criteria for early diagnosis of intestinal obstruction. Of all the most common acute surgical diseases of the abdominal cavity, acute intestinal obstruction gives the highest lethality. The main reason for this is untimely diagnosis. In two groups of patients, we performed a study of chronic peritoneal peritoneal disease using X-ray computed tomography (RCT), with obstruction (58 patients) and absence of this pathology (56 patients). Analyzing nonparametric statistics with the calculation of the Pearson criterion, with the Yates correction. We presented the criteria for the RCT study, differential diagnosis of adhesive intestinal obstruction from exacerbation of peritoneal adhesion. The main indicators of this disease: the fluid content in the lumen of the small intestine is more than 200.0 ml, in two or more regions, the inflated intestinal loops, an extension of 2.1 mm and more of the intestinal wall. The validity of the diagnostic criteria for RCT research leaves no doubt about the need for their use in preoperative access prognosis and the scope of surgical intervention.

scholarly journals Rare Forms of Intestinal Obstruction in Children

2019 ◽  
Vol 4 (2) ◽  
pp. 144-147 ◽  
Author(s):  
V. N. Stalmakhovich ◽  
I. N. Kaigorodova ◽  
A. S. Strashinsky ◽  
I. B. Li ◽  
E. V. Sapukhin
Keyword(s):  
Small Intestine ◽  
Intestinal Obstruction ◽  
Abdominal Cavity ◽  
Clinical Signs ◽  
Pancreatic Injury ◽  
Esophageal Stenosis ◽  
X Ray ◽  
First Child ◽  
Omental Bursa ◽  
Adhesive Intestinal Obstruction

The article analyzes two rare cases of acquired intestinal obstruction in children. In the first child at the age of 2 years, who suffered a retrosternal total coloesophagoplasty for extended post-burn chemical esophageal stenosis, early postoperative adhesive intestinal obstruction appeared on the 8th day of the postoperative period, which was eliminated laparoscopically. The next day, against the background of drug stimulation of the intestine, a small intestinal invagination developed, diagnosed with ultrasound examination. Relaparotomy and disinvagination were performed.The second patient, the 15 years old girl, who had suffered from closed abdominal injury and a pancreatic injury, manifested the signs of high partial intestinal obstruction a day after the trauma occurred. Initially, its cause was considered to be hematoma of the omental bursa. Fibrogastroduodenoscopy (FGDS) and X-ray diagnostics did not reveal the cause of intestinal obstruction, but after FGDS procedure the patient’s condition improved within 3–4 days, and then the clinical signs of small bowel obstructive adhesion confirmed by X-ray and laparoscopy. With laparoscopy in the middle section of the small intestine, a hyperinflate “whitish” section about 12 cm long, dense in palpation, was identified, which was the cause of obstruction. Through minilaparotomic umbilical access from the abdominal cavity, a loop of the jejunum with a foreign body inside was exteriorized. With transverse enterotomy trihobezoar 10×4×4 cm was removed from the lumen, which moved from the stomach and led to obstruction of small intestine. The outcome of the treatment was good in both cases.

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.

scholarly journals Closed loop obstruction and adhesive intestinal obstruction in perineal hernia

2020 ◽  
Vol 13 (12) ◽  
pp. e238112
Author(s):  
Ramprasad Rajebhosale ◽  
Mohammad Miah ◽  
Fraser Currie ◽  
Pradeep Thomas
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Rare Case ◽  
Transition Point ◽  
Closed Loop ◽  
Abdominoperineal Excision ◽  
Perineal Hernia ◽  
Bowel Gangrene ◽  
Adhesive Intestinal Obstruction

Perineal hernia with bowel gangrene is uncommon but known complication of laparoscopic extralevator abdominoperineal excision (ELAPE). We present a rare case of closed loop small bowel obstruction with bowel gangrene secondary to an incarcerated perineal hernia that developed 7 years after an ELAPE. Intraoperatively, we found a definitive transition point due to adhesions in pelvis and a closed loop obstruction of the distal small bowel at different site with gangrenous intestine. She was managed successfully surgically with adhesiolysis and fixation of defect with biological mesh. Prevalence of perineal hernias will rise in future because of the increasing cases of ELAPE, in which no repair of pelvic floor is performed. The need of follow-up of these operations and more reporting of such cases are important in increasing awareness of these complications. Patients should be made aware of such complications and should seek urgent medical care.

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