Second-look surgery following Hartmann's procedure for obstructive left-sided colorectal cancer

Causes of adverse outcomes in acute intestinal obstruction

OBJECTIVES

The purpose of this study is to analyse the effectiveness of methods of diagnosis and treatment of patients with acute intestinal obstruction.

METHODS

A total of 123 patients were examined, who were diagnosed based on history, an overview X-ray of the abdominal cavity, a contrast examination of the intestine, and contrast marks according to Yu. L. Shalkov and irrigoscopy. 57.4 % of patients had all typical aspects of the disease, 17.7 % - indolent aspects, and 4.8 % - atypical. In the case of colonic obstruction, the method of irrigoscopy is informative. To restore intestinal function, patients with acute intestinal obstruction of the small intestine are indicated with a Yu. L. Shalkov nasogastroenteral tube or a double-drainage nasointestinal tube. And with the colonic form of the disease, it is necessary to perform a Hartmann-type operation and establish a Maidl-type anastomosis.

RESULTS

It was noted that with indolent or atypical aspects of the disease, patients received medical care late. It is shown that in the case of resection of necrotic areas of the intestine, it is informative to determine the resection boundary using the vasoscopy method using a 1 % aqueous solution of methylene blue. It was found that the optimal distance from the edge of the resection is 3 cm.

CONCLUSIONS

The results of this study are of interest to clinicians who are engaged in the diagnosis and treatment of patients with acute intestinal obstruction.