Increased unenhanced bowel-wall attenuation: a specific sign of bowel necrosis in closed-loop small-bowel obstruction

Rondenet, Camille; Millet, Ingrid; Corno, Lucie; Boulay-Coletta, I.; Taourel, Patrice; Zins, Marc

doi:10.1007/s00330-018-5402-6

Cited by 33 publications

(30 citation statements)

References 21 publications

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“…Rondenet et al reported that increased unenhanced bowel wall attenuation was the only significant predictor of necrosis in strangulated closed-loop SBO [18]. In our study, a reduced enhancement of the intestinal wall and the existence of closed-loop obstruction were found to be independent predictive factors for bowel resection with SSBO.…”

Section: Discussionsupporting

confidence: 65%

A Study of the Prediction of Bowel Resection due to Strangulated Small Bowel Obstruction

Udaka

Taniguchi

et al. 2020

Preprint

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Background: In this retrospective study, we aimed to assess the predictive factors for bowel resection due to strangulated small bowel obstruction (SSBO). Methods: We enrolled a total of 109 patients diagnosed with SSBO at surgery. They were divided into two groups: those who underwent bowel resection and those who did not. The clinical findings, blood test results, blood gas analysis results, computed tomography (CT) findings, and sequential organ failure assessment (SOFA) scores of the patients were examined and compared between the two groups. Results: A univariate analysis indicated significant predictive factors to be a history of abdominal surgery, prolonged time from the onset of disease to the operation, increased C-reactive protein (CRP) level, decreased albumin, SOFA score, existence of closed-loop obstruction, and reduced enhancement of the intestinal wall at CT. A multivariate analysis indicated that a reduced enhancement of the intestinal wall and the existence of closed-loop obstruction were independent predictive factors. Strangulated bowel obstruction can progress to a serious condition. It is therefore crucial to predict preoperatively those patients who are likely to require bowel resection. Conclusions: Assessing the reduced enhancement of the intestinal wall and the existence of closed-loop obstruction are required in order to determine whether or not resection of the incarcerated intestine with SSBO is necessary. Key words: strangulated small bowel obstruction, prognostic factor, bowel resection, reduced enhancement of the intestinal wall, closed-loop obstruction

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Section: Discussionsupporting

confidence: 65%

A Study of the Prediction of Bowel Resection due to Strangulated Small Bowel Obstruction

Udaka

Taniguchi

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Rondenet et al reported that increased unenhanced bowel wall attenuation was the only signi cant predictor of necrosis in strangulated closed-loop SBO [22]. In our study, a reduced enhancement of the intestinal wall and the existence of closed-loop obstruction were found to be independent predictive factors for bowel resection with SSBO.…”

Section: Discussionsupporting

confidence: 64%

A Study of the Prediction of Bowel Resection due to Strangulated Small Bowel Obstruction

Udaka¹,

Taniguchi²,

J³

et al. 2020

Preprint

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Background In this retrospective study, we aimed to assess the predictive factors for bowel resection due to strangulated small bowel obstruction (SSBO). Methods We enrolled a total of 109 patients diagnosed with SSBO at surgery. They were divided into two groups: those who underwent bowel resection and those who did not. The clinical findings, blood test results, blood gas analysis results, computed tomography (CT) findings, and sequential organ failure assessment (SOFA) scores of the patients were examined and compared between the two groups. Results The 109 patients were divided into the bowel resection group (n = 38) and non-bowel resection group (n = 71). A univariate analysis indicated significant predictive factors to be a history of abdominal surgery, prolonged time from the onset of disease to the operation, increased C-reactive protein (CRP) level, decreased albumin, SOFA score, existence of closed-loop obstruction, and reduced enhancement of the intestinal wall at CT. A multivariate analysis indicated that a reduced enhancement of the intestinal wall and the existence of closed-loop obstruction were independent predictive factors. Strangulated bowel obstruction can progress to a serious condition. It is therefore crucial to predict preoperatively those patients who are likely to require bowel resection. Conclusions Assessing the reduced enhancement of the intestinal wall and the existence of closed-loop obstruction are required in order to determine whether or not resection of the incarcerated intestine with SSBO is necessary.

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“…The experience gained over several decades demonstrates the high value of the radiographic contrast study (RCS) of the intestine in the diagnosis of intestinal obstruction. Various methods of artificial enhancing have been developed and indications for their use have been clearly formulated depending on the anatomical and physiological characteristics of the examined site and the presence of particular clinical manifestations [ 1 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…The positive feature of the ultrasound examination is the determination of access for laparoscopic surgeries; simultaneously, the authors note that this method is accessory and cannot substitute computed tomography. The authors consider that the advantage of computed tomography, unlike ultrasound, is its independence from the researcher; it is fast and does not require barium and has high informativeness [ 1 , 5 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

Spiral Computed Tomography with Phytocomposition as a Diagnostic Tool for Adhesive Intestinal Obstruction

et al. 2020

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Background: Adhesive intestinal obstruction is a common and potentially lethal complication after surgical interventions in the abdomen. Radiologic imaging is the main diagnostic method. Objective: This study aims to analyse the diagnostic value of spiral computed tomography with a novel method (n = 54). Material and Methods: In this multidirectional cohort study, we present the data with non-parallel (historical) control. This study included the analysis of results of patients with a diagnosis of intestinal obstruction (n = 54) who were admitted to the surgical departments of the City Clinical Hospitals (Ufa city) from 2013 to 2019; the patients’ examination methods included computed tomography with conventional enhancement. The proposed novel enhancement method was implemented by ingesting a mixture containing 50 ml of the contrast Unigexol (300 mg) in 1.0 L cold mineral carbonated water, and Computed tomography (CT) was performed during 40 min after ingesting the contrast meal. Further, the patients with suspected obstruction in the colon were administered a pre-prepared contrast enema with a decoction of leaves of smoke-tree (100 g), chamomile flowers (100 g) and calendula flowers (100 g). Additionally, CT was performed. Results: Obstruction was conservatively stopped in 24 (44.4%) patients of the main group. Remaining 30 (55.6%) patients from the main group were operated with minimal surgical access in the early stages. Conclusion: Owing to early diagnosis of intestinal obstruction and application of the phytocomposition during the examination, exerting various effects such as antispasmodic, analgesic, disinfectant, bactericidal, cicatrising, choleretic, tanning and decongestant, unnecessary surgical interventions were prevented.

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Increased unenhanced bowel-wall attenuation: a specific sign of bowel necrosis in closed-loop small-bowel obstruction

Abstract: • Increased unenhanced bowel-wall attenuation is the only sign specific for necrosis • Decreased bowel-wall enhancement is not relevant for differentiating reversible ischemia from necrosis • Preoperative knowledge of bowel necrosis is helpful to plan adequate surgery.

Cited by 33 publications

References 21 publications

A Study of the Prediction of Bowel Resection due to Strangulated Small Bowel Obstruction

A Study of the Prediction of Bowel Resection due to Strangulated Small Bowel Obstruction

A Study of the Prediction of Bowel Resection due to Strangulated Small Bowel Obstruction

Spiral Computed Tomography with Phytocomposition as a Diagnostic Tool for Adhesive Intestinal Obstruction

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