scholarly journals Breath Hydrogen Gas Concentration Linked to Intestinal Gas Distribution and Malabsorption in Patients with Small-bowel Pseudo-obstruction

2009 ◽  
Vol 4 ◽  
pp. BMI.S2139 ◽  
Author(s):  
Yoshihisa Urita ◽  
Toshiyasu Watanabe ◽  
Tadashi Maeda ◽  
Yosuke Sasaki ◽  
Susumu Ishihara ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Close Association ◽  
Bacterial Overgrowth ◽  
Hydrogen Gas ◽  
Abdominal Radiograph ◽  
Breath Hydrogen ◽  
Plain Abdominal Radiograph ◽  
Intestinal Gas

Summary Background The patient with colonic obstruction may frequently have bacterial overgrowth and increased breath hydrogen (H2) levels because the bacterium can contact with food residues for longer time. We experienced two cases with intestinal obstruction whose breath H2 concentrations were measured continuously. Case 1 A 70-year-old woman with small bowel obstruction was treated with a gastric tube. When small bowel gas decreased and colonic gas was demonstrated on the plain abdominal radiograph, the breath H2 concentration increased to 6 ppm and reduced again shortly. Case 2 A 41-year-old man with functional small bowel obstruction after surgical treatment was treated with intravenous administration of erythromycin. Although the plain abdominal radiograph demonstrated a decrease of small-bowel gas, the breath H2 gas kept the low level. After a clear-liquid meal was supplied, fasting breath H2 concentration increased rapidly to 22 ppm and gradually decreased to 9 ppm despite the fact that the intestinal gas was unchanged on X-ray. A rapid increase of breath H2 concentration may reflect the movement of small bowel contents to the colon in patients with small-bowel pseudo-obstruction or malabsorption following diet progression. Conclusions Change in breath H2 concentration had a close association with distribution and movement of intestinal gas.

scholarly journals Sudden Unexpected Death Associated with Ileocecal Duplication Cyst and Clinical Review

2010 ◽  
Vol 4 ◽  
pp. CMPed.S4850 ◽  
Author(s):  
Y Kashiwagi ◽  
S. Suzuki ◽  
K. Watanabe ◽  
S. Nishimata ◽  
H. Kawashima ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Duplication Cyst ◽  
Multiple Organ ◽  
Watery Diarrhea ◽  
Abdominal Radiograph ◽  
Unexpected Death ◽  
Plain Abdominal Radiograph ◽  
Abdominal Symptoms

Duplications of the alimentary tract are very rare. A one-month-old female presented with symptoms of anorexia, vomiting and continuous watery diarrhea. The plain abdominal radiograph showed thickened intestinal wall and signs of small bowel obstruction. The fevers, vomiting, and continuous wartery diarrhea persisted despite antibiotics, and worsened. The patient failed to respond to medical managements, 27 hours after admission, the patient died due to multiple organ failures. The autopsy was performed, small bowel obstruction due to an ileocecal duplication cyst (3 × 3 cm) was recognized. The ileocecal duplication cyst was attached to the ileum which was changed edematous and necrotic. This potential diagnosis should be borne in mind for a patient who complains of abdominal symptoms with an unknown cause, and duplication cyst should be recognized as a fatal cause in infant.

scholarly journals Small bowel obstruction due to phytobezoar and adhesions following laparoscopic cholecystectomy

2015 ◽  
Vol 3 (2) ◽  
pp. 63
Author(s):  
Nidal Abu jkeim ◽  
Ahmad Al hazmi ◽  
Awad Alawad ◽  
Rashid Ibrahim ◽  
Ahmad Abu damis ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Abdominal Radiograph ◽  
Plain Abdominal Radiograph ◽  
History Of ◽  
Metallic Clip ◽  
Fluid Levels ◽  
Gallbladder Fossa

<p>We report a case of 51 –year-old female with history of laparoscopic cholecystectomy presented with abdominal pain and diagnosed as small bowel obstruction caused by adhesions. The initial presentation was periumbilical pain with nausea and vomiting. Plain abdominal radiograph showed dilated small bowel loops and multiple air fluid levels. Due to failure of conservative treatment, laparotomy was performed. An open metallic clip was adhering the bowel to the gallbladder fossa causing sharp angulation. A phytobezoar proximal to this angulation was exteriorized through enterotomy. The patient was recovered smoothly and discharged from our hospital.</p>

Accuracy of Computed Tomography in Small Bowel Obstruction

2013 ◽  
Vol 79 (6) ◽  
pp. 641-643 ◽  
Author(s):  
Rebecca E. Barnett ◽  
Jason Younga ◽  
Brady Harris ◽  
Robert C. Keskey ◽  
Daryl Nisbett ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Retrospective Chart Review ◽  
Clinical Findings ◽  
Abdominal Radiograph ◽  
Plain Abdominal Radiograph ◽  
Ischemic Bowel

Small bowel obstruction is a common clinical occurrence, primarily caused by adhesions. The diagnosis is usually made on the clinical findings and the presence of dilated bowel loops on plain abdominal radiograph. Computed tomography (CT) is increasingly used to diagnose the cause and location of the obstruction to aid in the timing of surgical intervention. We used a retrospective chart review to identify patients with a diagnosis of small bowel obstruction between 2009 and 2012. We compared the findings on CT with the findings at operative intervention. Sixty patients had abdominal CT and subsequent surgical intervention. Eighty-three per cent of CTs were correct for small intestine involvement and 80 per cent for colon involvement. The presence of adhesions or perforation was correctly identified in 21 and 50 per cent, respectively. Sixty-four per cent correctly identified a transition point. The presence of a mass was correctly identified in 69 per cent. Twenty per cent of the patients who had ischemic small bowel at surgery were identified on CT. CT has a role in the clinical assessment of patients with small bowel obstruction, identifying with reasonable accuracy the extent of bowel involvement and the presence of masses and transition points. It is less reliable at identifying adhesions, perforations, or ischemic bowel.

scholarly journals Automatic implantable cardioverter defibrillator (AICD) within the abdomen as a cause of adhesive small bowel obstruction (ASBO): a case report

2021 ◽  
Vol 2021 (9) ◽  
Author(s):  
Christopher J W Shean ◽  
Amir Butt
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Implantable Cardioverter Defibrillator ◽  
Bowel Obstruction ◽  
Conservative Management ◽  
Close Association ◽  
Bowel Habit ◽  
Adhesive Small Bowel Obstruction ◽  
Cardioverter Defibrillator ◽  
Automatic Implantable Cardioverter Defibrillator

Abstract Adhesive small bowel obstruction (ASBO) is commonly caused by intra-abdominal adhesions, usually from prior surgery. Conservative management is the mainstay of treatment, with adhesiolysis required for non-resolving obstruction. An unusual patient presentation of ASBO is presented here, where the cause is proposed as an automatic implantable cardioverter defibrillator (AICD) within the abdomen. Although the patient had several presentations of ASBO successfully treated with conservative management, a non-resolving obstruction required surgical management. At laparotomy, the AICD was found to be in close association with extensive matted adhesions to adjacent small bowel. Adhesiolysis was performed, with the AICD implanted in a subrectus pocket. The patient had an uncomplicated recovery, and at review 6 weeks following the operation was found to have a normal bowel habit with nil further episodes concerning for obstruction. This case highlights the importance of non-classical risk factors being a possible cause of ASBO.

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 Structural and quantitative alterations of gut microbiota in experimental small bowel obstruction

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255651
Author(s):  
Jiali Mo ◽  
Lei Gao ◽  
Nan Zhang ◽  
Jiliang Xie ◽  
Donghua Li ◽  
...  
Keyword(s):  
Small Bowel ◽  
Gut Microbiota ◽  
Small Bowel Obstruction ◽  
16S Rdna ◽  
Bowel Obstruction ◽  
High Throughput Sequencing ◽  
Bacterial Overgrowth ◽  
Polymerase Chain Reaction Analysis ◽  
Enzyme Linked Immunosorbent Assay ◽  
Rdna Sequences

Objective To investigate structural and quantitative alterations of gut microbiota in an experimental model of small bowel obstruction. Method A rat model of small bowel obstruction was established by using a polyvinyl chloride ring surgically placed surrounding the terminal ileum. The alterations of gut microbiota were studied after intestinal obstruction. Intraluminal fecal samples proximal to the obstruction were collected at different time points (24, 48 and 72 hours after obstruction) and analyzed by 16s rDNA high-throughput sequencing technology and quantitative PCR (qPCR) for target bacterial groups. Furthermore, intestinal claudin-1 mRNA expression was examined by real-time polymerase chain reaction analysis, and serum sIgA, IFABP and TFF3 levels were determined by enzyme-linked immunosorbent assay. Results Small bowel obstruction led to significant bacterial overgrowth and profound alterations in gut microbiota composition and diversity. At the phylum level, the 16S rDNA sequences showed a marked decrease in the relative abundance of Firmicutes and increased abundance of Proteobacteria, Verrucomicrobia and Bacteroidetes. The qPCR analysis showed the absolute quantity of total bacteria increased significantly within 24 hours but did not change distinctly from 24 to 72 hours. Further indicators of intestinal mucosa damage and were observed as claudin-1 gene expression, sIgA and TFF3 levels decreased and IFABP level increased with prolonged obstruction. Conclusion Small bowel obstruction can cause significant structural and quantitative alterations of gut microbiota and induce disruption of gut mucosa barrier.

Small Bowel Obstruction in Children: Usefulness of CT for Diagnosis and Localization

2007 ◽  
Vol 57 (6) ◽  
pp. 571
Author(s):  
Young Cheol Lee ◽  
Young Tong Kim ◽  
Won Kyung Bae ◽  
Il Young Kim
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction

An Uncommon An Uncommon Cause of Acute Abdomen in Underprivileged Communities

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
David Muchuweti ◽  
Hopewell Mungani ◽  
Hopewell Mungani ◽  
Farai Mahomva ◽  
Edwin Gamba Muguti ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Acute Abdomen ◽  
Bowel Obstruction ◽  
Bowel Wall ◽  
Haemodynamic Instability ◽  
Small Bowel Volvulus ◽  
General Surgeons ◽  
Heavy Infestation ◽  
Emergency Abdominal Surgery

Oftentimes general surgeons working in poorly resourced communities carry out emergency abdominal surgery in patients with acute abdomen with no definitive preoperative diagnosis. The definitive diagnosis is made at laparotomy. Perforated small bowel obstruction secondary to heavy Infestation with Ascaris Lumbricoides brings a number of intraoperative challenges requiring correct intraoperative surgical management decisions. We present a case of a 17 year-old patient who was admitted with a diagnosis of small bowel obstruction who at laparotomy was found to have perforated gangrenous small bowel volvulus with heavy worm load visible through the bowel wall. Because of faecal peritoneal contamination and haemodynamic instability she underwent a two staged procedure with good outcome.

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