[Intestinal obstruction in the late period after vagotomy due to gastric bezoars].
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Pharmacokinetic studies on kanamycin administered intramuscularly in a dose of 30 mg/kg 1 hour before a surgical operation to dogs with 48-hour occlusive ileus showed a high level of the antibiotic penetration into the blood, lymph and blood of the small intestinal vascular system. About 50 per cent of the kanamycin blood concentration was determined in the peritoneal exudate and up to 20 per cent was determined in the walls of the obturated and intact small intestine, mesentery and peritoneum. The peak of the antibiotic concentration in all biosubstrates tested was recorded by the lst hour from the moment of the antibiotic administration. The method of transillumination angiotensometry used in the studies provided estimation of the blood flow adequacy and measurement of the pressure in the parietal and intramural vessels of the small intestine. Still, no information on kanamycin distribution in tissues was provided with this method.
A comparative analysis of the results of treatment in 892 patients with various forms of acute bowel obstruction (ABO) of non-tumor genesis has been performed. High informative values of the intraoperative biomicroscopy of bowel wall for evaluation of severity of ischemic damage and viability of the intestine in ABO. The endotoxicosis (ET) in patients with ABO is proposed to be assessed on the basis of integral assessment of clinical and laboratory values of hemostasis. Basic principles of the choice of surgical policy and methods of detoxication in ABO with regard for the grade of ischemic damage of the bowel wall and the ET level are described. The application of the developed methods in patients with ABO allows to avoid mistakes in evaluation of bowel viability, to reduce the rate of development of toxicoseptic shock from 9.8% to 4.7% and to decrease postoperative lethality rate from 12.7% to 6.5%.
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Urachal remnant disorders are uncommon and may cause a wide spectrum of manifestations. We report a case of an inflamed urachal cyst causing acute small bowel obstruction in a 44-year-old male patient. The relevant literature is reviewed.
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