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Prospective evaluation of intestinal decompression in treatment of acute bowel obstruction from Crohn’s disease

Gastroenterology Report 2019年第4期7卷 263-271,I0002页

作者： Rui-Qing Liu Shuai-Hua Qiao Ke-Hao Wang Zhen Guo Yi Li Lei Cao Jian-Feng Gong Zhi-Ming Wang Wei-Ming Zhu Department of General Surgery Jinling HospitalMedical School of Nanjing UniversityNanjingJiangsuChina Department of Cardiology Drum Tower HospitalNanjing University Medical SchoolNanjingJiangsuChina

Background:Conservative therapy for Crohn’s disease(CD)-related acute bowel obstruction is essential to avoid emergent *** present study aimed to evaluate the efficacy of using a long intestinal decompression tube(LT)in treatment of CD with acute intestinal ***:This is a prospective observational *** analysis was performed in CD patients treated with LT(the LT group)and nasogastric tube(the GT group).The primary outcome was the avoidance of emergent ***,predictive factors for failure of decompression and subsequent surgery were ***:There were 27 and 42 CD patients treated with LT and GT,respectively,in emergent ***(44.4%)patients using LT were managed conservatively without laparotomy,while only nine(21.4%)patients in the GT group were spared from emergent surgery(P500mL were predictors of unavoidable surgery(both P0.05).Conclusions:Endoscopic placement of LT could improve the emergent status in CD patients with acute bowel *** drainage output and changes in C-reactive protein after intubation could serve as practical predictive indices for subsequent *** to traditional GT decompression,LT decompression was associated with fewer short-term complications and did not appear to affect long-term recurrence.

关键词： Intestinal decompression acute bowel obstruction Crohn’s disease emergent surgery

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acute bowel obstructions of the Elderly in a Low African Country

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Surgical Science 2022年第3期13卷 164-173页

作者： Kouame Bernadin Kouakou Kouakou Ibrahim Anzoua Mamadou Traore Ismael Kalou Leh Bi Ahou Bernadette N’Dri Aka Gerard Kakou Serge Amos Ekra Blaise Amos Kouakou Inza Bamba Djahou Ezechiel Akowendo Roger Lebeau Bamourou Diane General and Digestive Surgery Department University Hospital of Bouaké Bouake Ivory Coast

Background: acute bowel obstruction is one of the main causes of non-traumatic gastro—intestinal surgical emergencies. When they occur in elderly patients, they seem to induce higher morbi-mortality. The aim of our study was to identify the causes of these bowel obstructions in elderly patients and to expose the results of their surgical management. Patients and Methods: Retrospective and analytical study of patients aged 65 years and over, operated on between January 2013 and December 2019 for acute bowel obstruction at the University Hospital of Bouake. Demographic, diagnostic, therapeutic and evolutionary data were analysed. Results: The study involved 36 men and 23 women (sex ratio = 1.6). The mean age of these patients was 70 ± 4.6 years (65 and 90 years). A history and/or co-morbidities were found in 67.8% of them. Patients were classified as ASA I (20.3%), ASA II (42.4%), ASA III (33.9%) or ASA IV (3.4%). The average consultation time was 5.3 ± 4.1 days (2 days and 28 days). bowel obstructions were due to colonic volvulus (38.9%), colonic cancer (22%), postoperative adhesions (18.6%), strangulated groin hernia (16.9%) or internal bowel hernia (3.3%). Volvulated or necrotic bowel and resectable cancers were resected followed by immediate anastomosis or stoma. Near upstream stomas were performed for unresectable cancers. A herniorrhaphy for groin hernias and a mesenteric breach suture for internal hernia were performed after bowel disinterment. Adhesions were released. The time to surgery was 22.3 ± 12.4 hours (2 hours and 72 hours). The post-surgery morbidity was 32.2%, marked by parietal suppurations (47.4%). The post-surgery mortality was 16.9%. Hemodynamic or septic shock, ASA score ≥ III, bowel necrosis and ICU stay were the significant risk factors. Conclusion: acute bowel obstructions in the elderly are dominated by colonic volvulus. The high mortality is related to various factors highlighting the frailty of the elderly. A multidisciplinary management i

关键词： acute bowel obstruction Elderly Etiology Morbi Mortality Surgery

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