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Ma J, Jiang Y, Zhou C, Wang D, Zhao C, Zhang Y. Case report: Rupture of an ileus tube in a patient with recurrent rectal cancer. Front Oncol 2023; 13:1270728. [PMID: 38162506 PMCID: PMC10755397 DOI: 10.3389/fonc.2023.1270728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
The insertion of an ileus tube is an important treatment for intestinal obstruction. According to previous reports, jejunal intussusception has been reported as a complication associated with ileus tube placement. However, rupture of the weighted tip of an ileus tube has not been reported before. Herein, we report a 55-year-old Chinese woman who underwent radical proctectomy (DIXON) for rectal cancer and developed pelvic recurrence and lung metastasis 65 months after surgery, accompanied by symptoms of acute intestinal obstruction. An ileus tube was inserted before the operation (extensive total hysterectomy, bilateral adnexal resection, rectal Hartman operation, partial enterectomy, and intestinal adhesion lysis). Rupture of the ileus tube occurred after the operation and was treated with paraffin oil and enteral nutrition, and the metal beads and spring were eliminated through the colostomy. During the follow-up, the patient received targeted therapy plus immunotherapy, which was successful: the quality of life of the patient was excellent, and no obvious abnormal symptoms were found. Endoscopy-assisted ileus tube insertion should be performed under intravenous anesthesia, and a knot should be tied at the tip of the ileus tube before insertion so that the ileus tube can be inserted easily by grasping the thread with biopsy forceps(the "thread-knotting" method). With the above methods, the procedure of ileus tube insertion could be improved to reduce the incidence of tube-related rupture.
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Affiliation(s)
- Jun Ma
- Department of General Surgery, Anqing Municipal Hospital, Anqing, China
| | - Ye Jiang
- Department of Gastroenterology, Anqing Municipal Hospital, Anqing, China
| | - Chaoping Zhou
- Department of General Surgery, Anqing Municipal Hospital, Anqing, China
| | - Datian Wang
- Department of General Surgery, Anqing Municipal Hospital, Anqing, China
| | - Chunxia Zhao
- Department of General Surgery, Anqing Municipal Hospital, Anqing, China
| | - Yaming Zhang
- Department of General Surgery, Anqing Municipal Hospital, Anqing, China
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Brower CH, Baugh CW, Shokoohi H, Liteplo AS, Duggan N, Havens J, Askari R, Rehani MM, Kapur T, Goldsmith AJ. Point-of-care ultrasound-first for the evaluation of small bowel obstruction: National cost savings, length of stay reduction, and preventable radiation exposure. Acad Emerg Med 2022; 29:824-834. [PMID: 35184354 DOI: 10.1111/acem.14464] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/31/2022] [Accepted: 02/16/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Computed tomography (CT) has long been the gold standard in diagnosing patients with suspected small bowel obstruction (SBO). Recently, point-of-care ultrasound (POCUS) has demonstrated comparable test characteristics to CT imaging for the diagnosis of SBO. Our primary objective was to estimate the annual national cost saving impact of a POCUS-first approach for the evaluation of SBO. Our secondary objectives were to estimate the reduction in radiation exposure and emergency department (ED) length of stay (LOS). METHODS We created and ran 1000 trials of a Monte Carlo simulation. The study population included all patients presenting to the ED with abdominal pain who were diagnosed with SBO. Using this simulation, we modeled the national annual cost savings in averted advanced imaging from a POCUS-first approach for SBO. The model assumes that all patients who require surgery or have non-diagnostic POCUS exams undergo CT imaging. The model also conservatively assumes that a subset of patients with diagnostic POCUS exams undergo additional confirmatory CT imaging. We used the same Monte Carlo model to estimate the reduction in radiation exposure and total ED bed hours saved. RESULTS A POCUS-first approach for diagnosing SBO was estimated to save a mean (±SD) of $30.1 million (±8.9 million) by avoiding 143,000 (±31,000) CT scans. This resulted in a national cumulative decrease of 507,000 bed hours (±268,000) in ED LOS. The reduction in radiation exposure to patients could potentially prevent 195 (±56) excess annual cancer cases and 98 (±28) excess annual cancer deaths. CONCLUSIONS If adopted widely and used consistently, a POCUS-first algorithm for SBO could yield substantial national cost savings by averting advanced imaging, decreasing ED LOS, and reducing unnecessary radiation exposure in patients. Clinical decision tools are needed to better identify which patients would most benefit from CT imaging for SBO in the ED.
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Affiliation(s)
- Charles H. Brower
- Department of Emergency Medicine University of Cincinnati Medical Center Cincinnati Ohio USA
| | - Christopher W. Baugh
- Department of Emergency Medicine, Harvard Medical School Brigham and Women's Hospital Boston Massachusetts United States
| | - Hamid Shokoohi
- Department of Emergency Medicine, Harvard Medical School Massachusetts General Hospital Boston Massachusetts USA
| | - Andrew S. Liteplo
- Department of Emergency Medicine, Harvard Medical School Massachusetts General Hospital Boston Massachusetts USA
| | - Nicole Duggan
- Department of Emergency Medicine, Harvard Medical School Brigham and Women's Hospital Boston Massachusetts United States
| | - Joaquim Havens
- Department of Surgery, Division of Trauma, Burn, and Surgical Critical Care, Harvard Medical School Brigham and Women's Hospital Boston Massachusetts USA
| | - Reza Askari
- Department of Surgery, Division of Trauma, Burn, and Surgical Critical Care, Harvard Medical School Brigham and Women's Hospital Boston Massachusetts USA
| | - Madan M. Rehani
- Department of Radiology Massachusetts General Hospital Boston Massachusetts USA
| | - Tina Kapur
- Department of Radiology, Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA
| | - Andrew J. Goldsmith
- Department of Emergency Medicine, Harvard Medical School Brigham and Women's Hospital Boston Massachusetts United States
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Yamaguchi D, Ikeda K, Takeuchi Y, Kinoshita R, Higuchi T, Fukuda H, Tominaga N, Morisaki T, Ario K, Tsunada S, Yoshida H, Fujimoto K. New insertion method of transnasal ileus tube for small bowel obstruction: Anterior balloon method. PLoS One 2018; 13:e0207099. [PMID: 30462677 PMCID: PMC6248956 DOI: 10.1371/journal.pone.0207099] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 10/24/2018] [Indexed: 11/20/2022] Open
Abstract
Background Small bowel obstruction (SBO) is usually caused by postoperative adhesions and malignant disease, and decompression is effective for SBO. Our previous case report suggested that a new transnasal ileus tube insertion method, the anterior balloon method (ABM), could achieve decompression for adhesive SBO. Aims The study aimed to investigate the effectiveness of a new method for inserting transnasal ileus tubes in patients with SBO. Methods Altogether, 134 patients with small bowel obstruction treated from January 2011 to December 2017 were reviewed. The patients were categorized into two groups: those with the new method that inserts an anterior balloon (ABM group: 52 patients, 2014–2017) versus those with the ordinary insertion method (OIM group: 82 patients, 2011–2014). Results The patients’ characteristics and symptoms on admission were similar in the ABM and OIM groups. Adhesions were the main cause of ileus in the two groups. The insertion time duration was significantly shorter in the ABM group than in OIM group (28.4 ± 9.1 vs. 33.5 ± 13.0 min; p = 0.01). The ABM group also had significantly longer tubes than OIM group (222.4 ± 32.2 vs. 157.4 ± 31.7 cm; p < 0.001), which resulted in a significantly shorter time until clinical symptoms were relieved in ABM group. There were no significant differences in adverse events between the two groups. Conclusions The ABM group had shorter insertion duration and longer tubes than those of OIM group. The ABM might become a preferred therapeutic choice to achieve decompression in patients with SBO.
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Affiliation(s)
- Daisuke Yamaguchi
- Department of Gastroenterology, National Hospital Organization Ureshino Medical Center, Ureshino, Japan
- Department of Internal Medicine, Saga Medical School, Saga, Japan
- * E-mail:
| | - Kei Ikeda
- Department of Gastroenterology, National Hospital Organization Ureshino Medical Center, Ureshino, Japan
| | - Yuki Takeuchi
- Department of Gastroenterology, National Hospital Organization Ureshino Medical Center, Ureshino, Japan
| | - Rikako Kinoshita
- Department of Gastroenterology, National Hospital Organization Ureshino Medical Center, Ureshino, Japan
| | - Toru Higuchi
- Department of Internal Medicine, Saga Medical School, Saga, Japan
| | - Hiroko Fukuda
- Department of Gastroenterology, National Hospital Organization Ureshino Medical Center, Ureshino, Japan
| | - Naoyuki Tominaga
- Department of Internal Medicine, Saga Medical School, Saga, Japan
| | - Tomohito Morisaki
- Department of Gastroenterology, National Hospital Organization Ureshino Medical Center, Ureshino, Japan
| | - Keisuke Ario
- Department of Gastroenterology, National Hospital Organization Ureshino Medical Center, Ureshino, Japan
| | - Seiji Tsunada
- Department of Gastroenterology, National Hospital Organization Ureshino Medical Center, Ureshino, Japan
| | - Hisako Yoshida
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kazuma Fujimoto
- Department of Internal Medicine, Saga Medical School, Saga, Japan
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Bauer J, Keeley B, Krieger B, Deliz J, Wallace K, Kruse D, Dallas K, Bornstein J, Chessin D, Gorfine S. Adhesive Small Bowel Obstruction: Early Operative versus Observational Management. Am Surg 2015. [DOI: 10.1177/000313481508100627] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We assessed the nonoperative and operative management of adhesive small bowel obstruction (ASBO) and compared complication rates and surgical outcomes. ASBO is a common complication of abdominopelvic surgery. Although patients may respond to nonoperative management, many require surgery. We retrospectively studied patients admitted to Mount Sinai Hospital with a diagnosis of complete ASBO to determine outcomes of nonoperative management. Patients admitted with complete ASBO from 2001 to 2011 were included. Patients with no previous abdominopelvic surgery, surgery within the six weeks preceding admission and obstruction due to other identifiable causes, such as incarcerated hernia, were excluded. Complication rates and outcomes were compared between patients managed with immediate surgery and those managed initially with non-operative strategies. Of 460 patients admitted with complete ASBO, 106 (23.0%) had surgery within 24 hours of admission. At surgery, 20 (18.9%) had ischemic bowel and 8 (7.5%) had perforations. The remaining 354 patients had a trial of nonoperative management lasting at least 24 hours. Of 354 patients managed initially without surgery, 100 (28.2%) patients were discharged without operative intervention during their index admissions. Among the patients having surgery more than 24 hours after admission, indications for surgery were generally failure to resolve, worsening clinical status, and change in imaging findings. Of those patients observed for at least 24 hours, 40 (15.7%) were found to have ischemic bowel and 5 (2.0%) had perforation at surgery. Rates of bowel resection, stoma creation and postoperative complications were similar for the immediate and delayed surgery groups. Among the delayed surgery group, 71 (28.0%) required a bowel resection and 11 (4.3%) stoma creation. Twenty one per cent had postoperative complications, most commonly ileus. There were no statistically significant differences in the outcomes between immediate and delayed groups regardless of duration of delay. Among patients observed with complete ASBO, 24.6 per cent of patients with adhesive obstruction resolved without surgery or readmission. Delaying operative management did not affect surgical findings or complication rates.
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Affiliation(s)
- Joel Bauer
- Department of Surgery, Icahn School of Medicine, Mount Sinai Hospital, New York, New York
| | - Brieze Keeley
- Department of Surgery, Icahn School of Medicine, Mount Sinai Hospital, New York, New York
| | - Beth Krieger
- Department of Surgery, Icahn School of Medicine, Mount Sinai Hospital, New York, New York
| | - Juan Deliz
- Department of Surgery, Icahn School of Medicine, Mount Sinai Hospital, New York, New York
| | - Kojo Wallace
- Department of Surgery, Icahn School of Medicine, Mount Sinai Hospital, New York, New York
| | - Danielle Kruse
- Department of Surgery, Icahn School of Medicine, Mount Sinai Hospital, New York, New York
| | - Kai Dallas
- Department of Surgery, Icahn School of Medicine, Mount Sinai Hospital, New York, New York
| | - Joseph Bornstein
- Department of Surgery, Icahn School of Medicine, Mount Sinai Hospital, New York, New York
| | - David Chessin
- Department of Surgery, Icahn School of Medicine, Mount Sinai Hospital, New York, New York
| | - Stephen Gorfine
- Department of Surgery, Icahn School of Medicine, Mount Sinai Hospital, New York, New York
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Dickman E, Tessaro MO, Arroyo AC, Haines LE, Marshall JP. Clinician-performed abdominal sonography. Eur J Trauma Emerg Surg 2015; 41:481-92. [PMID: 26038027 DOI: 10.1007/s00068-015-0508-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 03/02/2015] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Point-of-care ultrasonography is increasingly utilized across a wide variety of physician specialties. This imaging modality can be used to evaluate patients rapidly and accurately for a wide variety of pathologic conditions. METHODS A literature search was performed for articles focused on clinician-performed ultrasonography for the diagnosis of appendicitis, gallbladder disease, small bowel obstruction, intussusception, and several types of renal pathology. The findings of this search were summarized including the imaging techniques utilized in these studies. CONCLUSION Clinician performed point-of-care sonography is particularly well suited to abdominal applications. Future investigations may further confirm and extend its utility at the bedside.
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Affiliation(s)
- E Dickman
- Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, NY, 11219, USA.
| | - M O Tessaro
- Division of Paediatric Emergency Medicine, The Hospital for Sick Children, Toronto, ON, M5G1X8, Canada
| | - A C Arroyo
- Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, NY, 11219, USA
| | - L E Haines
- Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, NY, 11219, USA
| | - J P Marshall
- Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, NY, 11219, USA
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Evaluation and management of small-bowel obstruction: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg 2013; 73:S362-9. [PMID: 23114494 DOI: 10.1097/ta.0b013e31827019de] [Citation(s) in RCA: 165] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Small-bowel obstruction (SBO) represents as many as 16% of surgical admissions and more than 300,000 operations annually in the United States. The optimal strategies for the diagnosis and management of SBO continue to evolve secondary to advances in imaging techniques, critical care, and surgical techniques. This updated systematic literature review was developed by the Eastern Association for the Surgery of Trauma to provide up-to-date evidence-based recommendations for SBO. METHODS A search of the National Library of Medicine MEDLINE database was performed using PubMed interface for articles published from 2007 to 2011. RESULTS The search identified 53 new articles that were then combined with the 131 studies previously reviewed by the 2007 guidelines. The updated guidelines were then presented at the 2012 annual EAST meeting. CONCLUSION Level I evidence now exists to recommend the use of computed tomographic scan, especially multidetector computed tomography with multiplanar reconstructions, in the evaluation of patients with SBO because it can provide incremental clinically relevant information over plains films that may lead to changes in management. Patients with evidence of generalized peritonitis, other evidence of clinical deterioration, such as fever, leukocytosis, tachycardia, metabolic acidosis, and continuous pain, or patients with evidence of ischemia on imaging should undergo timely exploration. The remainder of patients can safely undergo initial nonoperative management for both partial and complete SBO. Water-soluble contrast studies should be considered in patients who do not clinically resolve after 48 to 72 hours for both diagnostic and potential therapeutic purposes. Laparoscopic treatment of SBO has been demonstrated to be a viable alternative to laparotomy in selected cases.
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Guo SB, Duan ZJ. Decompression of the small bowel by endoscopic long-tube placement. World J Gastroenterol 2012; 18:1822-6. [PMID: 22553408 PMCID: PMC3332297 DOI: 10.3748/wjg.v18.i15.1822] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Revised: 11/24/2011] [Accepted: 03/10/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate and compare the decompression effect on small bowel obstruction of a long tube inserted using either endoscopic or fluoroscopic placement.
METHODS: Seventy-eight patients with small bowel obstruction requiring decompression were enrolled in the study and divided into two groups. Intubation of a long tube was guided by fluoroscopy in one group and by endoscopy in the other. The duration of the procedure and the success rate for each group were evaluated.
RESULTS: A statistically significant difference in the mean duration of the procedure was found between the fluoroscopic group (32.6 ± 14.6 min) and the endoscopic group (16.5 ± 7.8 min) among the cases classified as successful (P < 0.05). The success rate was significantly different between the groups: 88.6% in the fluoroscopic group and 100% in the endoscopic group (P < 0.05).
CONCLUSION: For patients with adhesive small bowel obstruction, long-tube decompression is recommended and long-tube insertion by endoscopy was superior to fluoroscopic placement.
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Development of a simple model for predicting need for surgery in patients who initially undergo conservative management for adhesive small bowel obstruction. Am J Surg 2010; 200:215-23. [PMID: 20591400 DOI: 10.1016/j.amjsurg.2009.07.045] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2009] [Revised: 06/05/2009] [Accepted: 07/09/2009] [Indexed: 12/13/2022]
Abstract
BACKGROUND Among patients with adhesive small bowel obstruction (ASBO) initially managed with a conservative strategy, predicting risk of operation is difficult. METHODS We investigated ASBO patients at 2 different periods to derive and validate a clinical prediction model for risk of operation. RESULTS One hundred fifty-four patients were enrolled into the derivation cohort and 96 into the validation cohort. Based on the derived scoring, including age > or =65 years, presence of ascites, and gastrointestinal drainage volume >500 mL on day 3, each patient was classified into 1 of 4 risk classes from low risk to high risk. When applied to the validation cohort, the positive predictive value (PPV) for operation in the high-risk class was 72%, while the negative predictive value (NPV) in the low-risk class was 100% with high sensitivity (100%) and specificity (96%). CONCLUSIONS The prediction model performs well for risk stratification of need for surgical intervention following conservative strategy among ASBO patients.
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Qalbani A, Paushter D, Dachman AH. Multidetector row CT of small bowel obstruction. Radiol Clin North Am 2008; 45:499-512, viii. [PMID: 17601505 DOI: 10.1016/j.rcl.2007.04.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
State-of-the-art multidetector row CT (MDCT) technology has revolutionized abdominal imaging. The ability of CT to determine if bowel obstruction is present, to localize the obstructive site, to determine degree of obstruction, to diagnose the presence of closed-loop obstruction, and to identify ischemia or perforation of the involved bowel is well established. This article illustrates the usefulness of MDCT in the evaluation of small bowel obstruction and related conditions in adults and emphasizes the benefits of advanced CT applications.
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Affiliation(s)
- Adnan Qalbani
- The University of Chicago, MC 2026, 5841 S. Maryland Ave., Chicago, IL 60637, USA.
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Maglinte DDT, Howard TJ, Lillemoe KD, Sandrasegaran K, Rex DK. Small-bowel obstruction: state-of-the-art imaging and its role in clinical management. Clin Gastroenterol Hepatol 2008; 6:130-9. [PMID: 18187365 DOI: 10.1016/j.cgh.2007.11.025] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Small-bowel obstruction (SBO) is a common clinical condition with signs and symptoms similar to other acute abdominal disorders. The radiologic investigation of patients with SBO as well as the indications and timing of surgical intervention have changed over the past 2 decades. This review focuses on modern imaging techniques and their role in both the diagnosis and treatment of patients with SBO.
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Affiliation(s)
- Dean D T Maglinte
- Department of Radiology, Indiana University Medical Center, Indianapolis, Indiana 46202-5253, USA.
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Hill A. The management of adhesive small bowel obstruction – An update. Int J Surg 2008; 6:77-80. [DOI: 10.1016/j.ijsu.2006.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2006] [Revised: 09/04/2006] [Accepted: 09/04/2006] [Indexed: 11/16/2022]
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Sakakibara T, Harada A, Ishikawa T, Komatsu Y, Yaguchi T, Kodera Y, Nakao A. Parameter predicting the recurrence of adhesive small bowel obstruction in patients managed with a long tube. World J Surg 2007; 31:80-5. [PMID: 17180476 DOI: 10.1007/s00268-006-0158-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Some of our patients showed a recurrence of adhesive small bowel obstruction (ASBO) with nonoperative management. The aim of this study was to evaluate the parameters predicting the recurrence of ASBO in patients managed with a long tube. METHODS Of 234 patients with ASBO admitted from April 1998 to September 2002, a total of 91 who recovered with nonoperative management after long tube placement were enrolled in this retrospective clinical study. We divided them into two groups for follow-up: the recurrence group and the no-recurrence group. We compared baseline characteristics, the number of previous ASBO admissions, the number of abdominal operations, the interval from the onset of symptoms to long-tube insertion, the duration of long-tube placement, the type of the contrasted intestine through the long tube, the location of the long-tube tip, and the drainage volume through the long tube between the two groups. We then examined the cumulative recurrence rate. RESULTS A significant difference was found in the number of previous ASBO admissions, the duration of long-tube placement (77 hours vs. 43 hours), the contrasted intestine through the long tube, and the location of the long-tube tip. By multivariate analysis, the duration of long-tube placement was an independent parameter predicting the recurrence of ASBO. CONCLUSIONS These results suggest that the duration of long-tube placement might serve as a parameter for predicting recurrence of ASBO in patients managed with a long tube.
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Affiliation(s)
- Takumi Sakakibara
- Gastroenterological Surgery, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan.
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Chen SC, Yen ZS, Wang HP, Lee CC, Hsu CY, Chen WJ, Hsu CY, Lai HS, Lin FY, Chen WJ. Ultrasonography in diagnosing colorectal cancers in patients presenting with abdominal distension. Med J Aust 2006; 184:614-6. [PMID: 16803440 DOI: 10.5694/j.1326-5377.2006.tb00415.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2005] [Accepted: 03/21/2006] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the usefulness of abdominal ultrasonography for diagnosing colorectal cancer in patients presenting with abdominal distension. DESIGN, SETTING AND PARTICIPANTS A prospective case series of consecutive adult patients with abdominal distension admitted to the National Taiwan University Hospital between January 2001 and July 2004. All participants were examined by abdominal ultrasonography. Those with suspected colorectal tumours on ultrasonography had follow-up colonoscopy, while all other patients had computed tomography scans. MAIN OUTCOME MEASURES Accuracy of abdominal ultrasonography for diagnosing colorectal cancer in patients with abdominal distension; incidence of colorectal cancer. RESULTS Of 511 patients eligible for inclusion in our study, 97 (19.0%) were confirmed to have colorectal cancer. For diagnosis of colorectal cancer, ultrasonography had a sensitivity of 92.8% (95% CI, 85.2%-96.8%); a specificity of 98.8% (95% CI, 97.0%-99.6%); a positive predictive value of 94.7% (95% CI, 87.6%-98.0%); a negative predictive value of 98.3% (95% CI 96.4%-99.3%); and an accuracy of 97.7%. CONCLUSION Ultrasonography is a sensitive tool for diagnosing colorectal cancer in patients presenting with abdominal distension.
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Affiliation(s)
- Shyr-Chyr Chen
- National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
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