Defining the Need for Surgery in Small-Bowel Obstruction

Kuehn, Florian; Weinrich, Malte; Ehmann, Sarah; Kloker, Katja; Pergolini, Ilaria; Klar, E.

doi:10.1007/s11605-017-3418-x

Cited by 22 publications

(16 citation statements)

References 14 publications

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“…The rest of the patients should receive conservative treatment. However, some patients after conservative treatment showed persisting or progressive symptoms and absence of contrast agent in the colon after 12 and 24 h [10]. The use of contrast agent swallow for patients with small-bowel obstructions enabled a timely and very accurate differentiation between patients qualifying for conservative and operative treatment [10].…”

Section: Discussionmentioning

confidence: 99%

“…However, some patients after conservative treatment showed persisting or progressive symptoms and absence of contrast agent in the colon after 12 and 24 h [10]. The use of contrast agent swallow for patients with small-bowel obstructions enabled a timely and very accurate differentiation between patients qualifying for conservative and operative treatment [10]. Conservative treatment is carried out by gastric aspiration using a nasogastric tube accomplished by inserting a nasogastric (NG) tube that suctions fluid from the stomach can often solve the problem, as this was the case in [1].…”

Section: Discussionmentioning

confidence: 99%

“…The Single-Balloon enterostomy has also been used in the diagnosis and treatment of some patients [9]. Due to its medico-surgical emergency nature, the management of medico-surgical intestinal obstruction frequently requires a multidisciplinary team [10] [11] [12]. Herein, we report the clinical, diagnostic, surgical, and therapeutic features of a case of intestinal obstruction induced by excessive consumption of wild grape seeds that we encountered for the first time in our practice as a surgeon for more than 20 years ago.…”

Section: Introductionmentioning

confidence: 99%

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Small Bowel Obstruction Induced by Phytobezoar: A Case Report in Innocent Abdomen and Literature Review

Traoré¹,

Traoré²,

Coulibaly³

et al. 2021

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Introduction: Small bowel obstruction (SBO) is defined as a complete and persistent cessation of the transit of materials and gases. It occurs in a segment of the digestive tract located between the pylorus and the colorectal junction. Herein, we report a case of small bowel obstruction (SBO) following excessive consumption of wild grapes with no previous abdomen medical or surgical history. Presentation of case: A 65-year-old male farmer presented with cessation of materials and gas associated with vomiting of food and then bilious. The abdomen was bloated and painful on palpation with a moving, painful mass in the left iliac fossa. The hypothesis of acute occlusion of the colon was retained and confirmed on the X-Ray which showed a dilation of small bowel with air-fluid levels. The diagnostic of acute SBO was retained. We performed urgently a median laparotomy. We found the dilation of the loops from the jejunum to the sigmoid colon with a compact mass at the sigmoid colon of 15 cm in length and 6 cm in diameter. We proceeded to crush the mass that was made up with wild grape seed fecal, and push it back to the rectum. The phytobezoar made up with wild grape seeds was extracted through the anus with the fingers after anal dilation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Small Bowel Obstruction Induced by Phytobezoar: A Case Report in Innocent Abdomen and Literature Review

Traoré¹,

Traoré²,

Coulibaly³

et al. 2021

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“…These account for up to 80 % of cases, while Crohn's disease, tumors, hernias and volvulus are far less common [12,13]. Only a subgroup (about 30-60 %) of patients with SBO will undergo surgery [14][15][16][17][18]. The mortality rate is increased if there is delay in diagnosis and if there are associated co-morbidities such as diabetes or cardiovascular, lung and neurological diseases [19].…”

Section: General Remarks and Clinical Presentationmentioning

confidence: 99%

Gastrointestinal Ultrasound (GIUS) in Intestinal Emergencies – An EFSUMB Position Paper

et al. 2020

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An interdisciplinary group of European experts summarizes the value of gastrointestinal ultrasound (GIUS) in the management of three time-critical causes of acute abdomen: bowel obstruction, gastrointestinal perforation and acute ischemic bowel disease. Based on an extensive literature review, statements for a targeted diagnostic strategy in these intestinal emergencies are presented. GIUS is best established in case of small bowel obstruction. Metanalyses and prospective studies showed a sensitivity and specificity comparable to that of computed tomography (CT) and superior to plain X-ray. GIUS may save time and radiation exposure and has the advantage of displaying bowel function directly. Gastrointestinal perforation is more challenging for less experienced investigators. Although GIUS in experienced hands has a relatively high sensitivity to establish a correct diagnosis, CT is the most sensitive method in this situation. The spectrum of intestinal ischemia ranges from self-limited ischemic colitis to fatal intestinal infarction. In acute arterial mesenteric ischemia, GIUS may provide information, but prompt CT angiography is the gold standard. On the other end of the spectrum, ischemic colitis shows typical ultrasound features that allow correct diagnosis. GIUS here has a diagnostic performance similar to CT and helps to differentiate mild from severe ischemic colitis.

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“…Treatment modalities include both operative and nonoperative management. Conservative, nonoperative management typically consists of bowel rest, intravenous fluid rehydration, and nasogastric intubation[ 3 ]. While most SBOs resolve without surgical intervention, an estimated 24% of SBOs require emergency surgery[ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Small bowel obstruction caused by a bezoar following an adult simultaneous liver-kidney transplantation: A case report

Pan

Kim

Campsen

et al. 2020

WJCC

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BACKGROUND Small bowel obstructions (SBOs) are common following a large intra-abdominal operation; however, SBOs caused by bezoars are unreported in patients following liver-kidney transplantation procedures, particularly in adults. CASE SUMMARY A 65-year-old Caucasian female presented with nausea and nonbilious emesis during her postoperative course following a simultaneous liver-kidney transplantation. She developed worsening nausea and vomiting with significant abdominal distension and obstipation. Computed tomography imaging showed a marked abnormal dilation of multiple small bowel loops with a distinct transition point that was suggestive of a small bowel obstruction. An exploratory laparotomy revealed a foreign body in the intestinal track approximately 30 cm from the ileocecal valve. The foreign body was extracted and identified as a bezoar with hair follicles and old digestive contents. Following the operation, the patient demonstrated rapid clinical improvement with resolution of nausea, emesis, and progress in bowel motility. CONCLUSION SBOs caused by bezoars can occur immediately following a liver-kidney transplantation and should not be discounted as a diagnosis.

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Defining the Need for Surgery in Small-Bowel Obstruction

Abstract: A straightforward algorithm based mainly on contrast agent swallow for patients with small-bowel obstructions enabled a timely and very accurate differentiation between patients qualifying for conservative and operative treatment.

Cited by 22 publications

References 14 publications

Small Bowel Obstruction Induced by Phytobezoar: A Case Report in Innocent Abdomen and Literature Review

Small Bowel Obstruction Induced by Phytobezoar: A Case Report in Innocent Abdomen and Literature Review

Gastrointestinal Ultrasound (GIUS) in Intestinal Emergencies – An EFSUMB Position Paper

Small bowel obstruction caused by a bezoar following an adult simultaneous liver-kidney transplantation: A case report

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