Current management of adhesive small bowel obstruction

Köstenbauer, Jakob; Truskett, Philip G.

doi:10.1111/ans.14556

Cited by 26 publications

(27 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Peritoneal adhesions, which were found in up to 95% of patients after intraabdominal surgery, are the leading cause of SBOs. 10,[19][20][21] When it comes to appendicitis, previous studies reported the rate of adhesive SBO after LA to be 1.4%. [22][23][24] In our study, 16 cases were included in the SBO group.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7] Small bowel obstructions (SBOs) can occur following any abdominal surgery, including appendectomy, secondary to adhesion formation. [8][9][10][11] Previous studies showed that the SBO rates following appendectomy were approximately 1%. [12][13][14] These studies have shown that the highest risk of SBO occurs in perforated and complicated appendicitis.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cytokines in abdominal exudate and serum predict small bowel obstruction following appendectomy

Ding

et al. 2020

ANZ Journal of Surgery

View full text Add to dashboard Cite

Background: This study aimed to investigate the value of inflammatory markers for the prediction of small bowel obstruction (SBO) following appendectomy. Methods: We included cases of acute appendicitis that underwent laparoscopic appendectomy (LA) in the Qingdao Municipal Hospital between January 2017 and January 2019. The cases were divided into an SBO group and a non-SBO group depending on whether patients had or did not have SBO, and patients were followed up for at least 1 year. The levels of interleukin (IL)-1β, IL-6 and tumour necrosis factor-alpha (TNF-α) in abdominal exudate and venous blood were examined using enzyme-linked immunosorbent assay. Results: After 1 year of follow-up, there were 985 cases in the non-SBO group and 16 cases in the SBO group. The levels of IL-1β, IL-6 and TNF-α in abdominal exudate on post-operative day 1 in the SBO group were 172.5 ± 14.7, 2167.3 ± 372.1 and 253.9 ± 12.9 pg/mL, respectively, which were significantly higher than that in the non-SBO group. The serum levels of IL-1β, IL-6, TNF-α and C-reactive protein (CRP) in the SBO group were significantly higher than that in the non-SBO group before surgery. Post-operatively, the inflammatory markers above decreased significantly and became similar with time in both groups. The logistic regression showed that the levels of peritoneal IL-6, preoperative serum CRP and perforated appendicitis were significant risk factors of SBO. The specificity and sensitivity of peritoneal IL-6 were 0.81 and 0.921, respectively. Conclusion: The IL-1β, IL-6, TNF-α and CRP in serum and abdominal exudate played an important role in SBO after LA. The peritoneal IL-6 was the most reliable prediction marker for SBO.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cytokines in abdominal exudate and serum predict small bowel obstruction following appendectomy

Ding

et al. 2020

ANZ Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…[25] Fluid resuscitation, electrolyte balancing, and nasogastric decompression are the initial treatments recommended for adhesive AMBO; however, while this initial treatment succeeds in some 80% of cases of partial obstruction, the rate is 40% for complete obstruction. [26] Water-soluble oral contrast agents have been used for conservative management of adhesive AMBO. Oral contrast agents reduced the need for surgery (20% vs 29% in controls) and the therapeutic effects were evident after 24 hours.…”

Section: Discussionmentioning

confidence: 99%

Etiology, Management, and Survival of Acute Mechanical Bowel Obstruction: Five-Year Results of A Training and Research Hospital in Turkey

Karakaş

Yeşiltaş

Gökçek

et al. 2019

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

BACKGROUND: Acute mechanical bowel obstruction (AMBO) is still a major surgical problem for emergency departments. The aim of this study was to evaluate AMBO in terms of etiology, management, and survival.METHODS: Data of the age, sex, etiology, management, and survival of patients who were hospitalized for bowel obstruction between January 2014 and December 2018 were evaluated retrospectively. Adhesions, tumors, hernias and peritoneal carcinomatosis were evaluated in detail. RESULTS:A total of 735 patients were included in the study. The obstruction was located in the small bowel (AMSBO) in 60% and in the large bowel (AMLBO) in 40%. The mean patient age was 59.9±16.02 years and 52.9% of the patients were male. Adhesion, tumor, and hernia were the most common etiologies of the overall AMBO group (43.3%, 26.2%, and 6%, respectively). The most common etiology for AMSBO was an adhesion (69.3%), while it was a tumor for AMLBO cases (61.6%). The most common management of AMBO patients was a conservative approach (53.2%; adhesions: 76.7%). Surgical palliation was performed in 24.9% (peritoneal carcinomatosis: 65.7%), and resection was performed in 21.9% (volvulus: 61.9%). The mortality rate in the group was 8.6%. The most common etiology was colorectal surgery (51.4%) for adhesions, colorectal cancer (93.8%) for tumors, and incisional hernia (47.7%) in cases of hernia-related AMBO. CONCLUSION:Adhesions, tumors, and hernias are the most common etiologies of AMBO. The incidence of femoral/inguinal hernia have decreased while that of incisional hernia has increased, and it was further observed that peritoneal carcinomatosis has now become as common as hernia as a cause. .). AMBO is described as small (AMSBO) or large (AMLBO) according to the level of the bowel obstruction, and complete or incomplete obstruction according to the discharge of gas. [2] AMBO is observed in the small bowel in 75% to 80% of cases and in the large bowel in 20% to 25%. [3] The etiology of AMBO varies according to considerations such as age, development of the country of occurrence, and the level of the obstruc- ORIGINAL ARTICLEAcute mechanical bowel obstruction (AMBO) is still one of the major surgical problems encountered in emergency departments. AMBO constitutes 3% of all emergency admissions and 15% of acute abdominal pain cases. AMBO is an important cause of mortality as well as costs, as it may involve a long hospital stay, readmissions, and reoperations. [1] AMBO is described as local blockage of intestinal content transit for reasons that may be intramural (e.g., invagination, bezoar,

show abstract

“…48 The ability of the CT scan to distinguish between ASBO caused by the single-band and matted adhesions is valuable for patient selection for laparoscopic adhesiolysis (LAL) and to optimize port placements. 49 Multidetector CT scan and multiplanar reformation enhance the diagnostic value of CT scans by providing better spatial resolution. Acute-angled, U-, or J-shaped pattern made up of proximal dilated and distal collapsed bowel loops suggests angulation/kinking, and this typically indicates ASBO caused by matted adhesions.…”

Section: Computed Tomography Scanmentioning

confidence: 99%

Adhesive small bowel obstruction – an update

Tong

Lingam

Shelat

2020

Acute Medicine & Surgery

View full text Add to dashboard Cite

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.

show abstract

Current management of adhesive small bowel obstruction

Cited by 26 publications

References 51 publications

Cytokines in abdominal exudate and serum predict small bowel obstruction following appendectomy

Cytokines in abdominal exudate and serum predict small bowel obstruction following appendectomy

Etiology, Management, and Survival of Acute Mechanical Bowel Obstruction: Five-Year Results of A Training and Research Hospital in Turkey

Adhesive small bowel obstruction – an update

Contact Info

Product

Resources

About