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[Characteristics of diagnosis and treatment of patients with an acute intestinal obstruction].

Results of treatment of 1035 patients with an acute intestinal impassability (AII) were analyzed. There were determined advantages of the ultrasonic investigation (USI) in comparison with roentgenological investigation. Diagnostic validity of USI, not depending on the All origin, had constituted 100% and of roentgenological investigation--33-78%. Modern diagnosis and adequate volume of operative intervention had permitted to improve the results of the patients treatment with All. The mortality rate had constituted 3.3% (43 patients died).

Acute Disease↗

[The effect of low-intensity laser radiation on the regional hemodynamics in strangulated intestinal obstruction].

In the experiment on 214 white rats, the effect of different types of low-intensive laser irradiation and existing methods of treatment on regional hemodynamics in strangulated ileus was studied. Combined use of ultraviolet and helium-neon lasers has to be proved to be the most effective. Ultraviolet laser irradiation contributed to increase in elasticity of the arterial wall and cupping off the vascular spasm, helium-neon irradiation had a stimulating effect on the tissues of the intestinal wall.

Animals↗

[Echography in congenital intestinal obstruction in newborn infants].

The authors used echography in order to reveal typical echographic signs of high and low bowel obstruction in 51 newborns. Although the use of echography often fails to establish the real cause of the bowel obstruction, it allows the determination of its level and in general promotes making the proper diagnosis.

Female↗

Intestinal obstruction and perforation caused by undigested Acacia sp leaves in langur monkeys.

During a 2-week period, 3 hanuman langurs (Presbytis entellus) died from severe fibrinopurulent and proliferative peritonitis. Partially digested plant material was identified in the necrotic abdominal debris of the 1st and 2nd langurs. In the 3rd, a phytobezoar that extended 17.5 cm distally from the pyloric area had caused a 1-cm perforation. Seven months later, surgery was performed on a douc langur (Pygathrix nemaeus) to remove 1 gastric and 2 intestinal phytobezoars composed primarily of undigested Acacia sp leaves. An analysis of Acacia sp leaves consumed by these langurs revealed a high cell wall concentration (40%, dry basis), with an exceedingly high proportion of this cell wall composed of indigestible lignin. It was concluded that the species of acacia (Acacia saligna and A longifolia) fed in these cases are inappropriate browse items for langurs.

Acacia↗

Giant hydronephrotic kidney mimicking intestinal obstruction.

We describe a case of small bowel obstruction in a thirty-year-old adult male, which was discovered to be on account of a large hydronephrotic nonfunctioning kidney. An emergency percutaneous nephrostomy alleviated the massive abdominal distension and symptoms of small bowel obstruction. We have reviewed the causes, differential diagnosis and discussed the manner of such a unique and rare presentation.

Abdominal Pain↗

Food bolus intestinal obstruction in a Chinese population.

BACKGROUND: The aim of the present study was to review the authors' experience of the diagnosis and management of food bolus obstruction in a Chinese population. METHODS: During the period 1990-96, 31 patients were treated for food bolus obstruction. The records of these patients were retrospectively reviewed. RESULTS: Eighteen patients (58%) had a history of previous gastric surgery and 13 patients (42%) had an intact gastrointestinal tract. The most common site of impaction was the terminal ileum, and a synchronous site of food bolus obstruction was present in 16% of cases. A total of 91% of the food bolus retrieved was phytobezoar. In 15 cases, the food bolus was successfully milked into the caecum. Enterotomy for removal was necessary in 12 patients, and two underwent small-bowel resection for necrosis. CONCLUSION: Food bolus obstruction affects not only those who have had previous gastric surgery, but also a significant proportion of those with an intact gastrointestinal tract.

Aged↗

Does the index operation influence the course and outcome of adhesive intestinal obstruction?

OBJECTIVE: To ascertain the incidence of obstruction after various operations and find out if the index operation influenced the course and outcome of adhesive small bowel obstruction. DESIGN: Retrospective study. SETTING: Teaching hospital, Israel. SUBJECTS: 190 of 248 patients who presented with small bowel obstruction between January 1980 and December 1994. INTERVENTIONS: All patients were treated conservatively and operated on only if they did not improve or deteriorated. MAIN OUTCOME MEASURES: Incidence of obstruction depending on site of index operation, and response to treatment. RESULTS: 46 Patients (24%) had undergone upper abdominal operations, 26 (14%) small bowel resection, 47 (25%) appendicectomy, 27 (14%) gynaecological operations, and 44 (23%) colonic resections. The annual incidence of obstructive complications among the 190 patients in the groups studied was highest after appendicectomy (3.1/year) and colonic resections (2.9/year) and lowest after operations on the gallbladder and pancreas (1.1/year). Postoperative adhesive obstruction presented earlier after operations on the small bowel (median 1 year, range 5.4-20) and colon (median 1 year, range 2.2-40) than after the other operations. 60 (32%) of patients with acute small bowel obstruction had a history of abdominal malignancy, and obstruction was more likely to be complete after small bowel resection (20/26, 77%) compared with 39/74 (53%) after appendicectomy or gynaecological surgery, 17/46 (37%) after upper abdominal surgery, and 15/44 (34%) after colonic resection. Patients who developed obstruction after colonic resection had the longest period of conservative treatment (median 60 hours, range 24-216) and had the highest morbidity (8/44, 18%) although only 2 required bowel resection. Two patients died, both after obstruction following upper abdominal operations. CONCLUSIONS: Patients who present with obstruction after small bowel resection are extremely likely to be completely obstructed. Perhaps the morbidity associated with obstruction after colonic resection could be reduced if patients were operated on earlier.

Adolescent↗