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European Surgery
Erschienen in: European Surgery 1/2016

01.02.2016 | Original Article

Small bowel emergencies: two surgical centers’ experience and literature review

verfasst von: Dr. Panagiotis Paliogiannis, M.D, Ph.D, Leonardo Delogu, Giovanni Contu, Antonio Luigi Cambilargiu, Antonio Mundula, Giovanni Sotgiu, Carlo Biddau, Federico Attene, Mario Trignano, Fabrizio Scognamillo

Erschienen in: European Surgery | Ausgabe 1/2016

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Summary

Background

Small bowel surgical emergencies are potentially life-threatening conditions. The aim of this study is to evaluate the clinical, diagnostic and therapeutic aspects of small bowel surgical emergencies to identify proper options for their management.

Methods

We retrospectively investigated 54 consecutive patients who underwent emergency surgery for small bowel disease. All clinical, surgical, and pathological data were collected from clinical records and referrals.

Results

Intraperitoneal adhesions were the main cause of small bowel obstruction, followed by abdominal wall defects (primitive and incisional hernias), phytobezoars, internal hernias, and neoplasias. The most frequent surgical procedure performed was adhesiolisis, followed by small bowel resections and correction of abdominal wall defects.

Conclusions

In-depth knowledge of the diseases which cause small intestine emergencies is crucial for emergency surgeons, given the absence of specific clinical, laboratory or radiological features, that makes the diagnosis and the decision to perform surgery challenging.
Vorheriger Artikel Cholecystectomy in patients aged 80 years and more following ERCP: is it necessary?
Nächster Artikel Extended versus standard lymphadenectomy in patients undergoing pancreaticoduodenectomy for periampullary adenocarcinoma: a prospective randomized single center trial
Literatur
1.
Cheadle WG, Garr EE, Richardson JD. The importance of early diagnosis of small bowel obstruction. Am Surg. 1998;54:565–9.
2.
3.
Yamada T. Textbook of gastroenterology. 1st ed. Philadelphia: JB Lippincott; 1991. pp. 37–42. (Approach to the Patient with the Acute Abdomen and Fever of Abdominal Origin)
4.
Quaïssi M, Gaujoux S, Veyrie N, et al. Post-operative adhesions after digestive surgery: their incidence and prevention: review of the literature. J Visc Surg. 2012;149:e104–14.CrossRef
5.
Schnüriger B, Barmparas G, Branco BC, et al. Prevention of postoperative peritoneal adhesions: a review of the literature. Am J Surg. 2011;201:111–21.CrossRefPubMed
6.
Menzies D, Ellis H. Intestinal obstruction from adhesions–how big is the problem? Ann R Coll Surg Engl. 1990;72:60–3.PubMedCentralPubMed
7.
Miller G, Boman J, Shrier I, et al. Natural history of patients with adhesive small bowel obstruction. Br J Surg. 2000;87:1240–7.CrossRefPubMed
8.
Van Der Krabben AA, Dijkstra FR, Nieuwenhuijzen M, et al. Morbidity and mortality of inadvertent enterotomy during adhesiotomy. Br J Surg. 2000;87:467–71.CrossRef
9.
Ray NF, Denton WG, Thamer M, et al. Abdominal adhesiolysis: inpatient care and expenditures in the United States in 1994. J Am Coll Surg. 1998;186:1–9.CrossRefPubMed
10.
van den Tol MP, Haverlag R, van Rossen ME, et al. Glove powder promotes adhesion formation and facilitates tumour cell adhesion and growth. Br J Surg. 2001;88:1258–63.
11.
Soybir GR, Köksoy F, Polat C, et al. The effects of sterile or infected bile and dropped gallstones in abdominal adhesions and abscess formation. Surg Endosc. 1997;11:711–3.CrossRefPubMed
12.
O’Leary DP, Coakley JB. The influence of suturing and sepsis on the development of postoperative peritoneal adhesions. Ann R Coll Surg Engl. 1992;74:134–7.PubMedCentralPubMed
13.
Schnüriger B, Barmparas G, Branco BC, et al. Prevention of postoperative peritoneal adhesions: a review of the literature. Am J Surg. 2011;201:111–21.CrossRefPubMed
14.
Sartelli M, Coccolini F, van Ramshorst GH, et al. WSES guidelines for emergency repair of complicated abdominal wall hernias. World J Emerg Surg. 2013;8:50.PubMedCentralCrossRefPubMed
15.
Newsom BD, Kukora JS. Congenital and acquired internal hernias: unusual causes of small bowel obstruction. Am J Surg. 1986;152:279–85.CrossRefPubMed
16.
Martin LC, Merkle EM, Thompson WM. Review of internal hernias: radiographic and clinical findings. AJR Am J Roentgenol. 2006;186:703–17.CrossRefPubMed
17.
Takeyama N, Gokan T, Ohgiya Y, et al. CT of internal hernias. Radiographics. 2005;25:997–1015.CrossRefPubMed
18.
Rudroff C, Balogh A, Hilswicht S. Internal transomental herniation with a trapped small bowel mimicking acute appendicitis. Int J Surg Case Rep. 2013;4:1153–5.PubMedCentralCrossRefPubMed
19.
Butterworth J, Cross T, Butterworth W, et al. Transmesenteric hernia: a rare cause of bowel ischaemia in adults. Int J Surg Case Rep. 2013;4:568–70.PubMedCentralCrossRefPubMed
20.
Akyildiz H, Artis T, Sozuer E, et al. Internal hernia: complex diagnostic and therapeutic problem. Int J Surg. 2009;7:334–7.CrossRefPubMed
21.
Palmieri G, Paliogiannis P, Scognamillo F, et al. Colorectal cancer epidemiology in an area with a spontaneous screening program. Acta Med Mediterr. 2013;29:231–4.
22.
DiSario JA, Burt RW, Vargas H, et al. Small bowel cancer: epidemiological and clinical characteristics from a population-based registry. Am J Gastroenterol. 1994;89:699–701.PubMed
23.
North JH, Pack MS. Malignant tumors of the small intestine: a review of 144 cases. Am Surg. 2000;66:46–51.PubMed
24.
Vallicelli C, Coccolini F, Catena F, et al. Small bowel emergency surgery: literature’s review. World J Emerg Surg. 2001;6:1.CrossRef
25.
Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer. 2003;97:934–59.CrossRefPubMed
26.
27.
Modlin IM, Oberg K, Chung DC, et al. Gastroenteropancreatic neuroendocrine tumours. Lancet Oncol. 2008;9:61–72.CrossRefPubMed
28.
Gill SS, Heuman DM, Mihas AA. Small intestinal neoplasms. J Clin Gastroenterol. 2001;33:267–82.CrossRefPubMed
29.
Grover S, Ashley SW, Raut CP. Small intestine gastrointestinal stromal tumors. Curr Opin Gastroenterol. 2012;28:113–23.CrossRefPubMed
30.
Paliogiannis P, Pulighe F, Trignano M. Gastrointestinal stromal tumors. Ann Ital Chir. 2011;82:515–6.PubMed
31.
Ridolfini MP, Cassano A, Ricci R, et al. Gastrointestinal stromal tumors. Ann Ital Chir. 2011;82:97–109.PubMed
32.
Biasco G, Velo D, Angriman I, et al. Gastrointestinal stromal tumors: report of an audit and review of the literature. Eur J Cancer Prev. 2009;18:106–16.CrossRefPubMed
33.
Fong Y, Coit DG, Woodruff JM, et al. Lymph node metastasis from soft tissue sarcoma in adults. Analysis of data from a prospective database of 1772 sarcoma patients. Ann Surg. 1993;217:72–7.PubMedCentralCrossRefPubMed
34.
Salemis NS, Panagiotopoulos N, Sdoukos N, et al. Acute surgical abdomen due to phytobezoar-induced ileal obstruction. J Emerg Med. 2013;44:e21–3.CrossRefPubMed
35.
Lo CY, Lau PW. Small bowel phytobezoars: an uncommon cause of small bowel obstruction. Aust N Z J Surg. 1994;64:187–9.CrossRefPubMed
36.
Wang PY, Wang X, Zhang L, et al. Bezoar-induced small bowel obstruction: clinical characteristics and diagnostic value of multi-slice spiral computed tomography. World J Gastroenterol. 2015;21:9774–84.PubMedCentralCrossRefPubMed
37.
Delabrousse E, Lubrano J, Sailley N, et al. Small-bowel bezoar versus small-bowel feces: CT evaluation. AJR Am J Roentgenol. 2008;191:1465–8.CrossRefPubMed
38.
Kvitting JP, Andersson P, Druvefors P. A phytobezoar in the acute abdomen. Am J Surg. 2009;197:e21–2.CrossRefPubMed
39.
Delogu L, Paliogiannis P, Fara A, et al. Actinomycotic ileal perforation: a case report and literature review. Acta Med Mediterr. 2013;29:741–4.
40.
41.
Kaya E, Yilmazlar T, Emiroğlu Z, et al. Colonic actinomycosis: report of a case and review of the literature. Surg Today. 1995;25:923–6.CrossRefPubMed
42.
Ormsby AH, Bauer TW, Hall GS. Actinomycosis of the cholecystic duct: case report and review. Pathology. 1998;30:65–7.CrossRefPubMed
43.
Markogiannakis H, Theodorou D, Toutouzas KG, et al. Persistent omphalomesenteric duct causing small bowel obstruction in an adult. World J Gastroenterol. 2007;13:2258–60.PubMedCentralCrossRefPubMed
44.
Sawada F, Yoshimura R, Ito K, et al. Adult case of an omphalomesenteric cyst resected by laparoscopic-assisted surgery. World J Gastroenterol. 2006;12:825–7.PubMedCentralPubMed
45.
Mahato NK. Obliterated, fibrous omphalo-mesenteric duct in an adult without Meckel’s diverticulum or vitelline cyst. Rom J Morphol Embryol. 2010;51:195–7.PubMed
46.
Güner A, Keçe C, Boz A, et al. A rare cause of small bowel obstruction in adults: persistent omphalomesenteric duct. Ulus Travma Acil Cerrahi Derg. 2012;18:446–8.CrossRefPubMed
47.
Sagar PM, MacFie J, Sedman P, May J, Mancey-Jones B, Johnstone D. Intestinal obstruction promotes gut translocation of bacteria. Dis Colon Rectum. 1995;38:640–4.CrossRefPubMed
48.
Maglinte DD, Heitkamp DE, Howard TJ, et al. Current concepts in imaging of small bowel obstruction. Radiol Clin North Am. 2003;41:263–83.CrossRefPubMed
49.
Choi HK, Chu KW, Law WL. Therapeutic value of gastrografin in adhesive small bowel obstruction after unsuccessful conservative treatment: a prospective randomized trial. Ann Surg. 2002;236:1–6.PubMedCentralCrossRefPubMed
50.
Abbas S, Bissett IP, Parry BR. Oral water soluble contrast for the management of adhesive small bowel obstruction. Cochrane Database Syst Rev. 2007 (3):CD 004651
51.
Ceresoli M, Coccolini F, Catena F, et al. Water-soluble contrast agent in adhesive small bowel obstruction: a systematic review and meta-analysis of diagnostic and therapeutic value. Am J Surg. 2015;S0002-9610(15):00424–9.
52.
Suri S, Gupta S, Sudhakar PJ, et al. Comparative evaluation of plain films, ultrasound and CT in the diagnosis of intestinal obstruction. Acta Radiol. 1999;40:422–8.CrossRefPubMed
53.
Frager DH, Baer JW, Rothpearl A, et al. Distinction between postoperative ileus and mechanical small-bowel obstruction: value of CT compared with clinical and other radiographic findings. AJR Am J Roentgenol. 1995;164:891–4.CrossRefPubMed
54.
Ros PR, Huprich JE. ACR appropriateness criteria on suspected small-bowel obstruction. J Am Coll Radiol. 2006;3:838–41.CrossRefPubMed
55.
Jackson PG, Raiji MT. Evaluation and management of intestinal obstruction. Am Fam Physician. 2011;83:159–65.PubMed
Metadaten
Titel
Small bowel emergencies: two surgical centers’ experience and literature review
verfasst von
Dr. Panagiotis Paliogiannis, M.D, Ph.D
Leonardo Delogu
Giovanni Contu
Antonio Luigi Cambilargiu
Antonio Mundula
Giovanni Sotgiu
Carlo Biddau
Federico Attene
Mario Trignano
Fabrizio Scognamillo
Publikationsdatum
01.02.2016
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 1/2016
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-015-0356-2

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