Early diagnosis of bowel obstruction and strangulation by computed tomography in emergency department

Pothiawala, Sohil; Gogna, Apoorva

doi:10.5847/wjem.j.issn.1920-8642.2012.03.012

Cited by 17 publications

(14 citation statements)

References 19 publications

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“…All patients underwent conventional chest radiography, and computerized thorax tomography, as suggested [16,17], and complete blood counts were analyzed.…”

Section: Methodsmentioning

confidence: 99%

Age differences in blunt chest trauma: a cross-sectional study

Kapıcıbaşı

2020

kitp

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Introduction: Trauma is the most common cause of presentation to hospital emergency services. After extremity and cranial injuries, blunt thoracic trauma is the third most common injury. Aim: In this study, we aimed to present and assess blunt chest trauma in adults aged below 65 and elderly (age ≥ 65). Material and methods: In this study, 130 patients (86 young (age 18-64) and 44 elderly (age ≥ 65)) who applied to the emergency department with blunt thoracic trauma between October 2017 and October 2019 were evaluated retrospectively. Results: Of the patients, 99 (76.1%) were male, and 31 (23.9%) were female. The mean age was 54.41 ±20.13 years, and the patients were between 18 and 95 years of age. The most common cause of blunt thoracic trauma in the elderly group was a fall (n = 27; 61.3%), while in-vehicle traffic accident was most common in the young group (n = 43; 50%). "Flail chest," which is observed as a complication after multiple rib fractures, was present in 1 patient in the young group and in 10 patients in the elderly group; the difference was statistically significant (p > 0.05). Seven (5.3%) patients died. The mean hospital stay was 5.1 (1-60) days, which was borderline-significantly higher in the elderly group (p = 0.056). Conclusions: Due to its life-threatening properties, the detection of blunt thorax trauma is a priority among multipletrauma patients. For this reason, an aggressive diagnosis and treatment approach is essential in the whole patient group, especially among the elderly.

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“…All patients underwent conventional chest radiography, and computerized thorax tomography, as suggested [16,17], and complete blood counts were analyzed.…”

Section: Methodsmentioning

confidence: 99%

Age differences in blunt chest trauma: a cross-sectional study

Kapıcıbaşı

2020

kitp

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“…Thus, a cluster of dilated loops or a 'sac-like appearance' of crowded small bowel loops must recall internal herniation (9). Identification of air-fluid levels, diminished or absent colon gas, dilated small intestinal loops and dilatation of caecum are significant radiological findings (8). In our case, we evaluated the patient initially with abdominal ultrasonography before methods based on radiation and determined the pre-diagnosis observing dilated jejunal loops.…”

Section: Discussionmentioning

confidence: 89%

Gebelikte Nadir Bir Akut Batın Nedeni: İnternal Herniasyon

Ural

Dağistanli

2020

Düzce Tıp Fakültesi Dergisi

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Internal herniation is one of the rare causes of intestinal obstruction. The most common causes of intestinal obstruction are adhesive bridges, volvulus, and invagination. The classic triad frequently seen in the clinic includes colic type abdominal pain, nausea/vomiting and absences of gas passage and defecation. It is very difficult to diagnose internal herniation during pregnancy due to the inability to see all clinical findings together, to confuse the findings with obstetric pain, and to the possible fetal side effects due to the application of radiological diagnostic methods. Because of high maternal and fetal mortality risk, it is important to make an early diagnosis and perform surgical intervention without any delay if necessary. In all pregnant women presenting with a diagnosis of acute abdomen, intestinal obstruction and the possibility of the internal herniation that may cause this clinical picture should be kept in mind.

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“…This form of obstruction is associated with higher risks of strangulation and infarction with a mortality risk of 10-35%. 23,24 PATHOGENESIS OF ACQUIRED ADHESIONS I NJURY TO THE peritoneal mesothelium and resulting local inflammation activates fibrinocoagulative pathways. 24 This results in increased cellular turnover, infiltration of inflammatory cells, and deposition of fibrinogen.…”

Section: Types Of Asbomentioning

confidence: 99%

Adhesive small bowel obstruction – an update

Tong

Lingam

Shelat

2020

Acute Medicine & Surgery

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Small bowel obstruction (SBO) accounts for 12–16% of emergency surgical admissions and 20% of emergency surgical procedures. Even with the advent of laparoscopic surgery, intra‐abdominal adhesions remain a significant cause of SBO, accounting for 65% of cases. History and physical examination are essential to identify signs of bowel ischemia as this indicates a need for urgent surgical exploration. Another critical aspect of evaluation includes establishing the underlying cause for obstruction and distinguishing between adhesive and non‐adhesive etiologies as adhesive SBO (ASBO) can be managed non‐operatively in 70–90% of patients. A patient with a history of abdominopelvic surgery along with one or more cardinal features of obstruction should be suspected to have ASBO until proven otherwise. Triad of severe pain, pain out of proportion to the clinical findings, and presence of an abdominal scar suggest possible closed‐loop obstruction. Computed tomography has higher sensitivity and specificity compared to plain films and is recommended by the Bologna guidelines. Correcting fluid and electrolyte imbalance is an initial crucial step to mitigate severe hypovolemia. Patients should proceed with surgery if symptoms of bowel compromise are present, or if symptoms do not resolve or have worsened. Surgery is indicated in patients with ischemia, strangulation, perforation, peritonitis, or failure of non‐operative treatment. With advances in minimal access technology and increasing experience, laparoscopic adhesiolysis is recommended. Mechanical adhesion barriers are an effective measure to prevent adhesion formation.

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Early diagnosis of bowel obstruction and strangulation by computed tomography in emergency department

Cited by 17 publications

References 19 publications

Age differences in blunt chest trauma: a cross-sectional study

Age differences in blunt chest trauma: a cross-sectional study

Gebelikte Nadir Bir Akut Batın Nedeni: İnternal Herniasyon

Adhesive small bowel obstruction – an update

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