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PubMed1982

Value of small bowel enema in incomplete intestinal obstruction.

The usefulness of small bowel enema X-ray examination was evaluated in 11 patients in whom a provisional diagnosis of incomplete small bowel obstruction was made. Dilute barium was introduced through a nasojejunal tube. In one patient intubation of the jejunum was unsuccessful. In six patients the suspected obstruction was confirmed and information obtained about the site of obstruction. The small bowel enema X-ray examination was normal in three patients and subsequent clinical outcome was uneventful. In one patient, with normal findings on small bowel enema X-ray examination, acute obstruction developed after two days, necessitating operation. Small bowel enema X-ray examination appears a worthwhile adjuvant to clinical assessment but decisions for operative intervention still need to be based on clinical evaluation of patients.

Adolescent↗
PubMed1996

Ascaris lumbricoides infestation as a cause of intestinal obstruction in children: experience with 87 cases.

PURPOSE: The purpose of this study is to describe the occurrence and management of bowel obstruction caused by Ascaris lumbricoides, a common parasite in warm climates that affects children with limited socioeconomic means. METHODS: Eighty-seven patients with intestinal infestation owing to Ascaris lumbricoides were treated in the past 10 years (1984-1994). There were 48 (55.2%) girls and 39 (44.8%) boys. The mean age was 4.6 years, with peak occurrence at 2 years of age. Half the patients had a history of passing worms by mouth or anus. The majority of patients, 64 (73.5%), presented with a subacute clinical course; 23 (26.5%) had acute presentation, with severe abdominal pain, fever, dehydratation, vomiting, and abdominal distension and required vigorous fluid resuscitation and emergency surgical intervention. Diagnosis was achieved with plain abdominal roentgenograms, which showed a "whirlpool" pattern of intraluminal worms in most cases. RESULTS: Six patients had been incorrectly diagnosed as having appendicitis; two cases had appendicitis owing to Ascaris in the cecum and distal ileum. The majority of cases with a subacute presentation respond to medical (anthelmintic) management using oral administration of racine oil and piperazine. Of the 23 patients taken to the operating room, 11 required external "milking" of the obstructing bolus of worms from the ileum into the colon, six required intestinal resection and end-to-end anastomosis, six had an appendectomy, and three needed an enterotomy to manually extract the worms. In one case, initial management consisted of an ileostomy because of intraoperative instability owing to sepsis. Subsequently, after stabilization and treatment with anthelmintic agents, closure of the stoma with an end-to-end ileocolostomy was performed. There was no significant postoperative morbidity or mortality. CONCLUSION: These observations suggest that physicians should have a high index of suspicion for parasitic infestation in warm climates where economically deprived children present with symptoms of intestinal obstruction. Ascaris lumbricoides may be the cause of these events in endemic areas. Oral piperazine and racine oil can successfully resolve most subacute cases; however, aggressive resuscitation and prompt surgical intervention in patients with intestinal obstruction result in a satisfactory outcome.

Adolescent↗
PubMedDate not supplied

Intestinal obstruction after totally extraperitoneal laparoscopic inguinal hernia repair.

Laparoscopic hernia repair is a frequently performed operation. Although it has many advantages over open inguinal hernia repair, laparoscopic surgery is not without complications. Small bowel obstruction is a complication unique to laparoscopic repair of inguinal hernias. It is reported following transabdominal preperitoneal repairs. We present a case of small bowel incarceration through a peritoneal defect after a totally extraperitoneal inguinal hernia repair. Techniques to avoid this complication are presented. The literature is reviewed.

Hernia, Inguinal↗
PubMed1999

Intestinal obstruction secondary to enteral feedings in burn trauma patients.

BACKGROUND: Enteral feeding is preferred for maintaining gut integrity and providing nutrition in trauma patients. Recent reports suggest that use of early enteral feeds is successful and that complications are rare. A recent burn patient, who suffered apparent bowel obstruction and perforation secondary to enteral feedings, led us to review our experience with mechanical complications of tube feedings. METHODS: We searched our registry of patients treated for acute burn trauma injury and identified patients treated for acute bowel obstruction in the past 3 years. RESULTS: Four patients were identified, ages 22 to 44, with burns of 6 to 92% total body surface area. Each required intubation and ventilatory support during initial treatment, complicated by adult respiratory distress syndrome and sepsis. We began enteral feeds 1 to 3 days after admission. At approximately 14 days after admission, each patient deteriorated clinically, which led to emergent abdominal exploration; the tube feedings caused bowel obstruction and associated complications. Each patient improved with laparotomy. CONCLUSION: Bowel obstruction, ischemic necrosis, or both, secondary to early and aggressive nutrition with a fiber supplemented enteral feeding is an uncommon, life-threatening complication. Understanding and early recognition of this potential complication are essential to prevention or successful treatment.

Adult↗
PubMed1985

[A common concept of the pathogenesis of intestinal obstruction].

On the basis of personal investigations and literature data the authors make a conclusion of the common nature of pathogenesis of acute ileus and various kinds of shock reactions. This common nature is determined by the character of trigger mechanisms of pathological reactions and formation of defense reactions of the patient.

Animals↗
PubMedDate not supplied

[Small intestine intubation during operative treatment of primary or recurring intestinal obstructions (author's transl)].

The author reports eight cases of recurrent obstruction treated by intubation of the small bowel. This technic, possible in any cases, avoids other long and often difficult technics. The tube used in those cases intends to maintain a normal circumference to the small bowel on all its length and to secure its permanent evacuation till it begins to function normally.

Adult↗
PubMed1991

[Surgical treatment of acute intestinal obstruction].

The experience with treatment of acute ileus for the 5 years in 1032 patients is summarized. Operated on were 269 patients. The different types of operative interventions with a wide use of intubation, adsorbents, laparostomy were performed. The postoperative lethality was 9.2%.

Acute Disease↗

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