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Sun B, Liu J, Li S, Lovell JF, Zhang Y. Imaging of Gastrointestinal Tract Ailments. J Imaging 2023; 9:115. [PMID: 37367463 DOI: 10.3390/jimaging9060115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/20/2023] [Accepted: 05/25/2023] [Indexed: 06/28/2023] Open
Abstract
Gastrointestinal (GI) disorders comprise a diverse range of conditions that can significantly reduce the quality of life and can even be life-threatening in serious cases. The development of accurate and rapid detection approaches is of essential importance for early diagnosis and timely management of GI diseases. This review mainly focuses on the imaging of several representative gastrointestinal ailments, such as inflammatory bowel disease, tumors, appendicitis, Meckel's diverticulum, and others. Various imaging modalities commonly used for the gastrointestinal tract, including magnetic resonance imaging (MRI), positron emission tomography (PET) and single photon emission computed tomography (SPECT), and photoacoustic tomography (PAT) and multimodal imaging with mode overlap are summarized. These achievements in single and multimodal imaging provide useful guidance for improved diagnosis, staging, and treatment of the corresponding gastrointestinal diseases. The review evaluates the strengths and weaknesses of different imaging techniques and summarizes the development of imaging techniques used for diagnosing gastrointestinal ailments.
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Affiliation(s)
- Boyang Sun
- Key Laboratory of Systems Bioengineering, School of Chemical Engineering and Technology, Frontiers Science Center for Synthetic Biology (Ministry of Education), Tianjin University, Tianjin 300350, China
| | - Jingang Liu
- Key Laboratory of Systems Bioengineering, School of Chemical Engineering and Technology, Frontiers Science Center for Synthetic Biology (Ministry of Education), Tianjin University, Tianjin 300350, China
| | - Silu Li
- Key Laboratory of Systems Bioengineering, School of Chemical Engineering and Technology, Frontiers Science Center for Synthetic Biology (Ministry of Education), Tianjin University, Tianjin 300350, China
| | - Jonathan F Lovell
- Department of Biomedical Engineering, The State University of New York at Buffalo, Buffalo, NY 14260, USA
| | - Yumiao Zhang
- Key Laboratory of Systems Bioengineering, School of Chemical Engineering and Technology, Frontiers Science Center for Synthetic Biology (Ministry of Education), Tianjin University, Tianjin 300350, China
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Demessence R, Lyoubi Y, Feuerstoss F, Hamy A, Aubé C, Paisant A, Venara A. Surgical management of adhesive small bowel obstruction: Is it still mandatory to wait? - An update. J Visc Surg 2022; 159:309-319. [PMID: 35272958 DOI: 10.1016/j.jviscsurg.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Small bowel obstruction syndromes (SBO) represent one of the main causes of emergency admission for surgical abdominal pain. The 2018 Bologna Guidelines (Ten Broek et al. 2018) recommend non-operative management at the outset if there are no signs of severity; surgery is proposed after 72h for the 20-30% of patients who fail medical management. However, these recommendations were based on old studies published at a time when laparoscopic surgery was not commonplace and when diagnostic capabilities (particularly for establishing etiology) were less developed than they are today. Additionally, the advent and development of laparoscopy and enhanced rehabilitation after surgery have led to a decrease in surgical morbidity. These guidelines are therefore now debated and several recent publications have encouraged urgent or semi-urgent surgical management for patients presenting for SBO in order to reduce morbidity, mortality, duration of hospitalization and costs, and to improve the feasibility of therapeutic laparoscopy. Prompt surgical management could also reduce the risk of recurrent small bowel obstructions. This model for early surgical management probably cannot be applied to all patients. It therefore seems important to select those patients at risk for failure of medical treatment and to identify those in whom the probability of successful laparoscopy is high. New radiological tools should allow better selection in the future. At the present time, the indications for early surgery "within 24h" should be emphasized.
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Affiliation(s)
- R Demessence
- Visceral and endocrine surgery department, CHU d'Angers, 4, rue Larrey, 49933 Angers Cedex 9, France; Faculty of Health of Angers, Department of Medicine, Angers, France
| | - Y Lyoubi
- Faculty of Health of Angers, Department of Medicine, Angers, France; Urology Department, CHU d'Angers, 49933 Angers Cedex 9, France
| | - F Feuerstoss
- Faculty of Health of Angers, Department of Medicine, Angers, France; Department of Radiology, CHU d'Angers, 49933 Angers Cedex 9, France
| | - A Hamy
- Visceral and endocrine surgery department, CHU d'Angers, 4, rue Larrey, 49933 Angers Cedex 9, France; Faculty of Health of Angers, Department of Medicine, Angers, France
| | - C Aubé
- Faculty of Health of Angers, Department of Medicine, Angers, France; Department of Radiology, CHU d'Angers, 49933 Angers Cedex 9, France; HIFIH, UPRES EA 3858, University of Angers, Angers, France
| | - A Paisant
- Faculty of Health of Angers, Department of Medicine, Angers, France; Department of Radiology, CHU d'Angers, 49933 Angers Cedex 9, France; HIFIH, UPRES EA 3858, University of Angers, Angers, France
| | - A Venara
- Visceral and endocrine surgery department, CHU d'Angers, 4, rue Larrey, 49933 Angers Cedex 9, France; Faculty of Health of Angers, Department of Medicine, Angers, France; HIFIH, UPRES EA 3858, University of Angers, Angers, France.
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Ten Broek RPG, Krielen P, Di Saverio S, Coccolini F, Biffl WL, Ansaloni L, Velmahos GC, Sartelli M, Fraga GP, Kelly MD, Moore FA, Peitzman AB, Leppaniemi A, Moore EE, Jeekel J, Kluger Y, Sugrue M, Balogh ZJ, Bendinelli C, Civil I, Coimbra R, De Moya M, Ferrada P, Inaba K, Ivatury R, Latifi R, Kashuk JL, Kirkpatrick AW, Maier R, Rizoli S, Sakakushev B, Scalea T, Søreide K, Weber D, Wani I, Abu-Zidan FM, De'Angelis N, Piscioneri F, Galante JM, Catena F, van Goor H. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group. World J Emerg Surg 2018; 13:24. [PMID: 29946347 PMCID: PMC6006983 DOI: 10.1186/s13017-018-0185-2] [Citation(s) in RCA: 220] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 05/29/2018] [Indexed: 02/06/2023] Open
Abstract
Background Adhesive small bowel obstruction (ASBO) is a common surgical emergency, causing high morbidity and even some mortality. The adhesions causing such bowel obstructions are typically the footprints of previous abdominal surgical procedures. The present paper presents a revised version of the Bologna guidelines to evidence-based diagnosis and treatment of ASBO. The working group has added paragraphs on prevention of ASBO and special patient groups. Methods The guideline was written under the auspices of the World Society of Emergency Surgery by the ASBO working group. A systematic literature search was performed prior to the update of the guidelines to identify relevant new papers on epidemiology, diagnosis, and treatment of ASBO. Literature was critically appraised according to an evidence-based guideline development method. Final recommendations were approved by the workgroup, taking into account the level of evidence of the conclusion. Recommendations Adhesion formation might be reduced by minimally invasive surgical techniques and the use of adhesion barriers. Non-operative treatment is effective in most patients with ASBO. Contraindications for non-operative treatment include peritonitis, strangulation, and ischemia. When the adhesive etiology of obstruction is unsure, or when contraindications for non-operative management might be present, CT is the diagnostic technique of choice. The principles of non-operative treatment are nil per os, naso-gastric, or long-tube decompression, and intravenous supplementation with fluids and electrolytes. When operative treatment is required, a laparoscopic approach may be beneficial for selected cases of simple ASBO.Younger patients have a higher lifetime risk for recurrent ASBO and might therefore benefit from application of adhesion barriers as both primary and secondary prevention. Discussion This guideline presents recommendations that can be used by surgeons who treat patients with ASBO. Scientific evidence for some aspects of ASBO management is scarce, in particular aspects relating to special patient groups. Results of a randomized trial of laparoscopic versus open surgery for ASBO are awaited.
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Affiliation(s)
- Richard P G Ten Broek
- 1Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.,39Department of Surgery, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Pepijn Krielen
- 1Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | | | - Walter L Biffl
- 4Acute Care Surgery, The Queen's Medical Center, Honolulu, Hawaii USA
| | - Luca Ansaloni
- 3General Emergency and Trauma Surgery, Bufalini hospital, Cesena, Italy
| | - George C Velmahos
- 5Department of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Boston, MA USA
| | | | - Gustavo P Fraga
- Faculdade de Ciências Médicas (FCM), Unicamp Campinas, São Paulo, Brazil
| | | | | | - Andrew B Peitzman
- 10Department of Surgery, Trauma and Surgical Services, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - Ari Leppaniemi
- Second Department of Surgery, Meilahti Hospital, Helsinki, Finland
| | | | | | - Yoram Kluger
- Division of General Surgery Rambam Health Care Campus Haifa, Haifa, Israel
| | - Michael Sugrue
- General Surgery Department, Letterkenny Hospital, Letterkenny, Ireland
| | - Zsolt J Balogh
- 16Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW Australia
| | | | - Ian Civil
- 18Department of Vascular and Trauma Surgery, Auckland City Hospital, Auckland, New Zealand
| | - Raul Coimbra
- 19Department of Surgery, UC San Diego Health System, San Diego, USA
| | - Mark De Moya
- Trauma, Acute Care Surgery Medical College of Wisconsin/Froedtert Trauma Center Milwaukee, Milwaukee, Wisconsin USA
| | - Paula Ferrada
- 21Virginia Commonwealth University, Richmond, VA USA
| | - Kenji Inaba
- 22Division of Trauma & Critical Care, LAC+USC Medical Center, University of Southern California, Los Angeles, CA USA
| | - Rao Ivatury
- 21Virginia Commonwealth University, Richmond, VA USA
| | - Rifat Latifi
- 23Department of General Surgery, Westchester Medical Center, Westchester, NY USA
| | - Jeffry L Kashuk
- 24Department of General Surgery, Assuta Medical Centers, Tel Aviv, Israel
| | | | - Ron Maier
- Department of Surgery, Harborview Medical Centre, Seattle, USA
| | - Sandro Rizoli
- 27Trauma & Acute Care Service, St Michael's Hospital, Toronto, ON Canada
| | - Boris Sakakushev
- 28Department of General Surgery, University of Medicine Plovdiv, Plovdiv, Bulgaria
| | - Thomas Scalea
- 29R Adams Crowley Shock Trauma Center, University of Maryland, Baltimore, USA
| | - Kjetil Søreide
- 30Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway.,31Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Dieter Weber
- 32Department of General Surgery, Royal Perth Hospital, The University of Western Australia and The University of Newcastle, Perth, Australia
| | - Imtiaz Wani
- 33Department of Surgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Fikri M Abu-Zidan
- 34Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Nicola De'Angelis
- 35Unit of Digestive Surgery, HPB Surgery and Liver Transplant, Henri Mondor Hospital, Créteil, France
| | | | - Joseph M Galante
- 37Trauma and Acute Care Surgery and Surgical Critical Care Trauma, Department of Surgery, University of California, Davis, USA
| | - Fausto Catena
- Emergency and Trauma Surgery, Parma Maggiore hospital, Parma, Italy
| | - Harry van Goor
- 1Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
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