scholarly journals Factors Predicting the Need for Early Surgical Intervention for Small Bowel Obstruction

2020 ◽  
Vol 36 (4) ◽  
pp. 223-228 ◽  
Author(s):  
Young Jae Cho ◽  
In Seok Park ◽  
Jungbin Kim ◽  
Hyun Jin Cho ◽  
Geum Hee Gwak ◽  
...  
Keyword(s):  
Treatment Group ◽  
Small Bowel ◽  
Conservative Treatment ◽  
Small Bowel Obstruction ◽  
Operative Treatment ◽  
Bowel Obstruction ◽  
Clinical Characteristics ◽  
Surgical Intervention ◽  
Common Disease ◽  
Leukocyte Counts

Purpose: Small bowel obstruction (SBO) is a common disease that requires hospitalization. The most common cause of SBO is postoperative adhesion. Delayed timing of operations in patients who need surgical intervention results in mortality or morbidity. A number of studies on SBO have established criteria for emergency surgery. However, few objective clinical parameters are available for screening patients who need a delayed operation. Therefore, we analyzed factors that affect the clinical course of SBO to select appropriate therapeutic plans for reducing the risk of complications in these patients.Methods: We investigated the clinical characteristics of patients admitted to the surgery department of our hospital between January 1, 2015, and December 31, 2016, who were diagnosed with SBO. Patients were divided into an operative treatment group (n = 12) and a conservative treatment group (n = 96). We compared clinical characteristics between the 2 groups.Results: The operative treatment group underwent more operations before SBO than the conservative treatment group (P = 0.007). Initial leukocyte counts (P = 0.004) and C-reactive protein (CRP) levels (P = 0.028) were elevated in the operative group. Body mass index (BMI) was lower in the operative group (P = 0.013).Conclusion: The number of operations before SBO, leukocyte counts, CRP levels, and BMI were useful parameters for selecting patients who needed an urgent operation for SBO.

scholarly journals MAIN ASPECTS OF ADHESIVE SMALL BOWEL OBSTRUCTION

2021 ◽  
pp. 269-279
Author(s):  
M.K. GULOV ◽  
◽  
D.S. SALIMOV ◽  
S.G. ALI-ZADE ◽  
A.R. DOSTIEV ◽  
...  
Keyword(s):  
Small Bowel ◽  
Conservative Treatment ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Treatment Method ◽  
Long Term Results ◽  
Adhesive Small Bowel Obstruction ◽  
Results Of Treatment ◽  
Abdominal Organs

Immediacy of the problem of acute adhesive small bowel obstruction (AASBO) is due to its high prevalence and presence of certain difficulties in diagnosis, which affect the choice of the treatment method. In addition, the long-term results of treatment cannot be considered satisfactory due to the large number of AASBO recurrences. In 64-93% of cases, adhesions form on the abdominal organs after surgery. It should be noted that their recurrence after open surgery reaches 30% of cases, and after repeated operations this value increases to 78%. Determination of the main etiological factor is of great importance, which makes it possible to assess the feasibility surgery, since it is known that if adhesions do not develop, treatment can be conservative. In this regard, X-ray methods of investigation can be of great help. Surgical intervention is recommended in the presence of intestinal dysfunction symptoms that do not disappear after conservative treatment or when it worsens. Surgical intervention is recommended if symptoms of intestinal dysfunction do not disappear after conservative treatment or if they deteriorate. n recent decades, specialists in the field of abdominal surgery have been striving to expand the indications for laparoscopic interventions in order to reduce the invasiveness of surgery, which will also decrease the risk of adhesions.

scholarly journals Small Bowel Obstruction Induced by Concurrent Postoperative Intra-Abdominal Adhesions and Small Bowel Fecal Materials in a Young Dog

2021 ◽  
Vol 8 (5) ◽  
pp. 83
Author(s):  
Jae-Eun Hyun ◽  
Hyun-Jung Han
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Gastrointestinal Symptoms ◽  
Exploratory Laparotomy ◽  
Abdominal Adhesions ◽  
Abdominal Radiography ◽  
Foreign Body Removal ◽  
Small Intestinal

A 7-month-old neutered male poodle dog presented with general deterioration and gastrointestinal symptoms after two separate operations: a jejunotomy for small-intestinal foreign body removal and an exploratory laparotomy for diagnosis and treatment of the gastrointestinal symptoms that occurred 1 month after the first surgery. The dog was diagnosed as having small-bowel obstruction (SBO) due to intra-abdominal adhesions and small-bowel fecal material (SBFM) by using abdominal radiography, ultrasonography, computed tomography, and laparotomy. We removed the obstructive adhesive lesion and SBFM through enterotomies and applied an autologous peritoneal graft to the released jejunum to prevent re-adhesion. After the surgical intervention, the dog recovered quickly and was healthy at 1 year after the surgery without gastrointestinal signs. To our knowledge, this study is the first report of a successful treatment of SBO induced by postoperative intra-abdominal adhesions and SBFM after laparotomies in a dog.

Recurrence After Operative Treatment of Adhesive Small-Bowel Obstruction

2017 ◽  
Vol 22 (2) ◽  
pp. 329-334 ◽  
Author(s):  
Lea Lorentzen ◽  
Mari N Øines ◽  
Erling Oma ◽  
Kristian K Jensen ◽  
Lars N Jorgensen
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Operative Treatment ◽  
Bowel Obstruction ◽  
Adhesive Small Bowel Obstruction

scholarly journals SMALL BOWEL OBSTRUCTION SECONDARY TO OBTURATOR HERNIA: A PRE-OPERATIVE DIAGNOSIS AT COMPUTED TOMOGRAPHY

2021 ◽  
Vol 6 (1) ◽  
pp. 46-49
Author(s):  
Marlina Tanty Ramli ◽  
Mohd Shukry Mohd Khalid ◽  
Kartini Rahmat
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Elderly Patients ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Obturator Hernia ◽  
Uneventful Recovery ◽  
Presenting Symptoms

Obturator hernia is rare, but it must be considered in elderly patients who present with small bowel obstruction. The diagnosis is challenging unless there is a high index of suspicion as the presenting symptoms and signs are usually non-specific. Presence of positive Howship-Romberg sign is considered pathognomonic. Early diagnosis and rapid surgical intervention will reduce the high morbidity and mortality associated with undiagnosed obturator hernia. We report a case of a 93-year-old female patient who was admitted to our surgical department with symptoms of intestinal obstruction of 3-days duration. Howship-Romberg sign was negative. Computed tomography (CT) demonstrated the presence of left obturator hernia with proximal small bowel obstruction and no sign of strangulation. The patient had emergency laparotomy post-CT where the incarcerated bowel loop was released and the obstructed bowel was decompressed without any complication. The hernial defect was close with a mesh and the patient had an uneventful recovery post-surgery. In this case, we highlight that diagnosis of obturator hernia must always be considered in elderly patients who present with intestinal obstruction. Urgent CT could establish a rapid pre-operative diagnosis and aids inappropriate surgical intervention planning which is crucial in optimising the outcome.

scholarly journals Therapeutic Role of Gastrograffin in Adhesive Small Bowel Obstruction After Unsuccessful Conservative Treatment

Med Phoenix ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 26-31
Author(s):  
MD Alam Shahid ◽  
Pashupati Bhatta ◽  
Akash Raya ◽  
Binod Kumar Rai
Keyword(s):  
Small Bowel ◽  
Conservative Treatment ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Open Appendectomy ◽  
Sampling Technique ◽  
Exploratory Laparotomy ◽  
Water Soluble ◽  
Adhesive Small Bowel Obstruction ◽  
Therapeutic Role

Background: The management of adhesive small bowel obstruction is quite debatable. Gastrograffin, a water-soluble hyperosmolar contrast is used as a diagnostic tool widely but it also has impressive therapeutic role. Hence this study was to determine its therapeutic role in management of adhesive bowel obstruction after failure of conservative treatment. Methods: This cross-section observational study of 42 patients was conducted in 1-year duration from 01 July 2018 to 30 June 2019 using non-probability purposive sampling technique. All the patients were first managed conservatively for 48 hrs, and then given 100ml of gastrograffin through NG tube and clamped. Appearance of dye in cecum on radiograph at different time frame (4, 8, 12 and 24 hours of administration) signifies the success and who failed to do so within 24 hrs. were planned for laparotomy. Results: A total of 42 patients with their age ranged 14-80 years (mean 44.6) were included. Among them 32 (76.19%) were male and 10 (23.80%) female. Most had open appendectomy followed by gynaecological surgery and exploratory laprotomy. Majority had midline incision followed by gridiron and pfanensteil incision. After 8 hrs of gastrograffin administration, it was positive in 12 patients while 19 had at 24 hrs. Total 31 patients showed complete resolution, while remaining 11 showed no improvement and undergone exploratory laparotomy. Conclusion: Thus, the administration of gastrograffin is an effective approach in the management of adhesive small bowel obstruction after failed conservative management and prevents surgeries.  

scholarly journals Association of Surgical Intervention for Adhesive Small-Bowel Obstruction With the Risk of Recurrence

JAMA Surgery ◽  
2019 ◽  
Vol 154 (5) ◽  
pp. 413 ◽  
Author(s):  
Ramy Behman ◽  
Avery B. Nathens ◽  
Stephanie Mason ◽  
James P. Byrne ◽  
Nicole Look Hong ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Adhesive Small Bowel Obstruction ◽  
Risk Of Recurrence

scholarly journals Endometriosis of the appendix causing small bowel obstruction in a virgin abdomen

2019 ◽  
Vol 12 (7) ◽  
pp. e230496 ◽  
Author(s):  
Joseph Do Woong Choi ◽  
Michael Yunaev
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Oestrogen Receptor ◽  
Surgical Intervention ◽  
Prior History ◽  
Good Recovery ◽  
History Of

A 29-year-old, otherwise well, nulligravid woman presented to the emergency department with 1-day history of generalised abdominal pain and vomiting. She had similar symptoms 6 months prior following recent menstruations, which resolved conservatively. She had no prior history of abdominal surgery or endometriosis. CT scan demonstrated distal small bowel obstruction. A congenital band adhesion was suspected, and she underwent prompt surgical intervention. During laparoscopy, a thickened appendix was adhered to a segment of distal ileum. There was blood in the pelvis. Laparoscopic adhesiolysis and appendicectomy were performed. Histopathology demonstrated multiple foci of endometriosis of the appendix with endometrial glands surrounded by endometrial stroma. Oestrogen receptor and CD10 immunostains highlighted the endometriotic foci. The patient made a good recovery and was referred to a gynaecologist for further management.

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