Current Management of Small-Bowel Obstruction

Hayanga, Awori J.; Bass-Wilkins, Kirsten; Bulkley, Gregory B.

doi:10.1016/j.yasu.2005.05.001

Cited by 111 publications

(80 citation statements)

References 71 publications

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“…As observed by Suh et al (17) , the main site of intestinal obstruction in our study was the small bowel (58.8%), followed by the colon (37%). Like other authors (1,4,8,11,13) , intestinal adhesions were the main cause of intestinal obstruction in our series, with 43% of cases. Unlike in developed countries and certain regions of Africa, where respectively hernia and volvulus of the colon represent the second leading cause of intestinal obstruction (1,9) , we observed high proportion of cancer incidence.…”

Section: Discussionsupporting

confidence: 86%

“…Postoperative peritoneal adhesions account for 60% to 75% of cases of small bowel in adults (6,10,17) . Other causes of intestinal obstruction include malignant neoplasia, herniae, inflammatory bowel diseases and volvulus (8) . The result is a surgical entity with a great diversity of presentation usually demanding a large scale of diagnostic methods and therapeutic modalities (7) .…”

Section: Introductionmentioning

confidence: 99%

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Analysis of the videolaparoscopy potentiality in the surgical treatment of the bowel obstruction

Ghezzi

Moschetti

Corleta

et al. 2010

Arq. Gastroenterol.

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-Context -Laparotomy is the gold standard treatment of patients with intestinal obstruction without response to clinical management. Nowadays, literature has been demonstrating the feasibility of videolaparoscopy in the treatment of intestinal obstruction. Objectives -To report the clinical-epidemiological profile of patients with intestinal obstruction submitted to surgery and verify the presence of contraindications for laparoscopy. Methods -It was done a observational, descriptive and retrospective study including adults patients with intestinal obstruction submitted to surgery at Hospital de Clínicas de Porto Alegre, RS, Brazil, between January of 2004 and October of 2008. Results -It was included 135 patients in the study, with a total of 126 patients submitted to open surgery and 9 to laparoscopy. There was similar distribution between gender and the mean age was 59 years (SD ± 16.9). The most frequent site of obstruction was the small bowel and the most frequent etiology was adhesions. Among the patients submitted to laparotomy, 75.4% presented with abdominal distention, 68.3% previous abdominal surgery, 11.9% body mass index >30 kg/m 2 , 4.8% coagulopathy and 3.2% hemodynamic instability. Among the 135 patients, only 5 of them presented with none contraindications for videolaparoscopy. Conclusion -The epidemiological findings of this study are similar to the ones of the worldwide literature. Indications of videolaparoscopy in retrospective analyses have the limitation of subjective evaluation of intestinal obstruction, which was included in this study as a relative contraindication to laparoscopy. HEADINGS -Intestinal obstruction. Video-assisted surgery.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Analysis of the videolaparoscopy potentiality in the surgical treatment of the bowel obstruction

Ghezzi

Moschetti

Corleta

et al. 2010

Arq. Gastroenterol.

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“…Contrast studies, such as a small bowel follow-through, can be helpful in the diagnosis of a partial intestinal obstruction in patients with high clinical suspicion and in clinically stable patients in whom initial conservative management was not effective [18]. The use of water-soluble contrast material is not only diagnostic, but may also be therapeutic in patients with partial smallbowel obstruction [19].…”

Section: Contrast Radiographymentioning

confidence: 99%

Laparoscopic Management of Acute Intestinal Obstruction

Salama¹

2017

Surgery Curr Res

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“…Trois caractéristiques à la TDM ont fréquemment été associées à la prise en charge chirurgicale, en plus de faire l'objet d'une bonne concordance entre les radiologistes : obstruction intesti nale complète, dilatation du grêle de plus de 4 cm et point de transition (ou saut de calibre). Le point de transition a été le seul facteur prédictif important à l'égard de la prise en charge chirurgicale de l'occlusion du grêle à l'analyse de régression logistique multivariée (rapport de cotes 19; intervalle de confiance de 95 %, 1,; p = 0,014).…”

Section: Résultatsunclassified

Computed tomography features associated with operative management for nonstrangulating small bowel obstruction

Suri

Vora

Kirby

et al. 2014

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Background:The management of nonstrangulating small bowel obstruction (SBO) may require surgery, but the need for and timing of surgical intervention isn't always apparent. We sought to determine whether specific features on computed tomog raphy (CT) can predict the necessity for operative management.Methods: Two radiologists independently reviewed CT scans from all patients admitted to hospital with SBO between 2004 and 2006. We examined the associ ation between radiographic features and operative management by univariate analysis using the χ 2 or Fisher exact test. Significant factors with high concor dance between radiologists were entered into a multivariable stepwise logistic regression model. Results:There were 228 patients with SBO, 63 of whom met our inclusion criteria and had CT scans available for review. Three CT features were frequently associated with operative management and had good concordance between radiologists: com plete bowel obstruction, small bowel dilation greater than 4 cm and transition point. Transition point was the only significant factor predictive of operative management for SBO on multivariable logistic regression analysis (OR 19, 95% confidence interval 1.8-201, p = 0.014). Conclusion:In patients with nonstrangulating SBO, the presence of a transition point on CT scan should alert the surgeon to the increased likelihood that operative management may be required.

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Current Management of Small-Bowel Obstruction

Cited by 111 publications

References 71 publications

Analysis of the videolaparoscopy potentiality in the surgical treatment of the bowel obstruction

Analysis of the videolaparoscopy potentiality in the surgical treatment of the bowel obstruction

Laparoscopic Management of Acute Intestinal Obstruction

Computed tomography features associated with operative management for nonstrangulating small bowel obstruction

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