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Benign GI diease
Factors Predicting the Need for Early Surgical Intervention for Small Bowel Obstruction
Young Jae Cho, In Seok Park, Jungbin Kim, Hyun Jin Cho, Geum Hee Gwak, Keun Ho Yang, Byung Noe Bae, Ki Hwan Kim
Ann Coloproctol. 2020;36(4):223-228.   Published online January 31, 2020
DOI: https://doi.org/10.3393/ac.2019.09.30
  • 4,089 View
  • 168 Download
  • 5 Web of Science
  • 6 Citations
AbstractAbstract PDF
Purpose
Small bowel obstruction (SBO) is a common disease that requires hospitalization. The most common cause of SBO is postoperative adhesion. Delayed timing of operations in patients who need surgical intervention results in mortality or morbidity. A number of studies on SBO have established criteria for emergency surgery. However, few objective clinical parameters are available for screening patients who need a delayed operation. Therefore, we analyzed factors that affect the clinical course of SBO to select appropriate therapeutic plans for reducing the risk of complications in these patients.
Methods
We investigated the clinical characteristics of patients admitted to the surgery department of our hospital between January 1, 2015, and December 31, 2016, who were diagnosed with SBO. Patients were divided into an operative treatment group (n = 12) and a conservative treatment group (n = 96). We compared clinical characteristics between the 2 groups.
Results
The operative treatment group underwent more operations before SBO than the conservative treatment group (P = 0.007). Initial leukocyte counts (P = 0.004) and C-reactive protein (CRP) levels (P = 0.028) were elevated in the operative group. Body mass index (BMI) was lower in the operative group (P = 0.013).
Conclusion
The number of operations before SBO, leukocyte counts, CRP levels, and BMI were useful parameters for selecting patients who needed an urgent operation for SBO.

Citations

Citations to this article as recorded by  
  • The predictive role of computed tomography with oral contrast in the successful management of adhesive small bowel obstruction
    Mohamed Khattab, Amr Ayad, Sameh Aziz, Peter Alaa, Marie N. Grace, Mohamed Saber
    The Egyptian Journal of Surgery.2024; 43(1): 16.     CrossRef
  • Associated factors with non operative management failure in bowel obstruction
    Omar Gutierrez Moreno, Nicolas Arredondo Mora, Oscar Rincon Barbosa, Francisco Gil Quintero
    Surgery Open Digestive Advance.2024; 16: 100185.     CrossRef
  • Predictive factors for operative intervention and ideal length of non-operative trial in adhesive small bowel obstruction
    Tara van Veen, Purushotham Ramanathan, Lolita Ramsey, Jonathan Dort, Dina Tabello
    Surgical Endoscopy.2023; 37(11): 8628.     CrossRef
  • Surgical management of adhesive small bowel obstruction: Is it still mandatory to wait? – An update
    R. Demessence, Y. Lyoubi, F. Feuerstoss, A. Hamy, C. Aubé, A. Paisant, A. Venara
    Journal of Visceral Surgery.2022; 159(4): 309.     CrossRef
  • Prise en charge chirurgicale des syndromes occlusifs de l’intestin grêle sur bride et adhérences postopératoires : faut-il toujours attendre ?
    R. Demessence, Y. Lyoubi, F. Feuerstoss, A. Hamy, C. Aubé, A. Paisant, A. Venara
    Journal de Chirurgie Viscérale.2022; 159(4): 326.     CrossRef
  • Small bowel obstruction
    David J. Detz, Jerica L. Podrat, Jose C. Muniz Castro, Yoon K. Lee, Feibi Zheng, Shawn Purnell, Kevin Y. Pei
    Current Problems in Surgery.2021; 58(7): 100893.     CrossRef
Small Bowel Obstruction After Ileal Pouch-Anal Anastomosis With a Loop Ileostomy in Patients With Ulcerative Colitis
Hitoshi Kameyama, Yoshifumi Hashimoto, Yoshifumi Shimada, Saki Yamada, Ryoma Yagi, Yosuke Tajima, Takuma Okamura, Masato Nakano, Kohei Miura, Masayuki Nagahashi, Jun Sakata, Takashi Kobayashi, Shin-ichi Kosugi, Toshifumi Wakai
Ann Coloproctol. 2018;34(2):94-100.   Published online April 30, 2018
DOI: https://doi.org/10.3393/ac.2017.06.14
  • 7,311 View
  • 111 Download
  • 8 Web of Science
  • 10 Citations
AbstractAbstract PDF
Purpose
Small bowel obstruction (SBO) remains a common complication after pelvic or abdominal surgery. However, the risk factors for SBO in ulcerative colitis (UC) surgery are not well known. The aim of the present study was to clarify the risk factors associated with SBO after ileal pouch-anal anastomosis (IPAA) with a loop ileostomy for patients with UC.
Methods
The medical records of 96 patients who underwent IPAA for UC between 1999 and 2011 were reviewed. SBO was confirmed based on the presence of clinical symptoms and radiographic findings. The patients were divided into 2 groups: the SBO group and the non-SBO group. We also analyzed the relationship between SBO and computed tomography (CT) scan image parameters.
Results
The study included 49 male and 47 female patients. The median age was 35.5 years (range, 14–72 years). We performed a 2- or 3-stage procedure as a total proctocolectomy and IPAA for patients with UC. SBO in the pretakedown of the loop ileostomy after IPAA occurred in 22 patients (22.9%). Moreover, surgical intervention for SBO was required for 11 patients. In brief, closure of the loop ileostomy was performed earlier than expected. A multivariate logistic regression analysis revealed that the 2-stage procedure (odds ratio, 2.850; 95% confidence interval, 1.009–8.044; P = 0.048) was a significant independent risk factor associated with SBO. CT scan image parameters were not significant risk factors of SBO.
Conclusion
The present study suggests that a 2-stage procedure is a significant risk factor associated with SBO after IPAA in patients with UC.

Citations

Citations to this article as recorded by  
  • Risk Factors for Stoma Outlet Obstruction after Proctocolectomy for Ulcerative Colitis
    Keisuke Ihara, Takatoshi Nakamura, Masashi Takayanagi, Junki Fujita, Yasunori Maeda, Yusuke Nishi, Norisuke Shibuya, Hiroyuki Hachiya, Mitsuru Ishizuka, Keiichi Tominaga, Kazuyuki Kojima, Atsushi Irisawa
    Journal of the Anus, Rectum and Colon.2024; 8(1): 18.     CrossRef
  • Ileostomy volvulus as an underreported problem causing small bowel obstruction in patients living with ostomy: a case report and literature review
    Julianna Seo, Ishith Seth, Dilshad Dooreemeah, Chun Hin Angus Lee
    Annals of Coloproctology.2024; 40(5): 424.     CrossRef
  • Management of J-pouch Complications
    Beatrix H. Choi, David Cohen, Caleah Kitchens, David M. Schwartzberg
    Surgical Clinics of North America.2024;[Epub]     CrossRef
  • Influence of the rotation of the diverting loop ileostomy in rectal cancer surgery on small-bowel obstruction: A multicenter prospective study conducted by the Clinical Study Group of Osaka University, Colorectal Group
    Masaaki Miyo, Mamoru Uemura, Yuki Ozato, Junichi Nishimura, Ken Nakata, Yozo Suzuki, Yoshinori Kagawa, Taishi Hata, Koji Munakata, Mitsuyoshi Tei, Genta Sawada, Shinichi Yoshioka, Yusuke Takahashi, Koji Oba, Tsuyoshi Hata, Takayuki Ogino, Norikatsu Miyosh
    Surgery.2024;[Epub]     CrossRef
  • Association Between Advanced T Stage and Thick Rectus Abdominis Muscle and Outlet Obstruction and High-Output Stoma After Ileostomy in Patients With Rectal Cancer
    Yasuhiro Komatsu, Kunitoshi Shigeyasu, Sho Takeda, Yoshiko Mori, Kazutaka Takahashi, Nanako Hata, Kokichi Miyamoto, Hibiki Umeda, Yoshihiko Kakiuchi, Satoru Kikuchi, Shuya Yano, Shinji Kuroda, Yoshitaka Kondo, Hiroyuki Kishimoto, Fuminori Teraishi, Masahi
    International Surgery.2022; 106(3): 102.     CrossRef
  • Obstructive and secretory complications of diverting ileostomy
    Shingo Tsujinaka, Hideyuki Suzuki, Tomoya Miura, Yoshihiro Sato, Chikashi Shibata
    World Journal of Gastroenterology.2022; 28(47): 6732.     CrossRef
  • Risk factors and management of stoma-related obstruction after laparoscopic colorectal surgery with diverting ileostomy
    Ryo Maemoto, Shingo Tsujinaka, Yasuyuki Miyakura, Rintaro Fukuda, Nao Kakizawa, Tsutomu Takenami, Erika Machida, Nozomi Kikuchi, Rina Kanemitsu, Sawako Tamaki, Hideki Ishikawa, Toshiki Rikiyama
    Asian Journal of Surgery.2021; 44(8): 1037.     CrossRef
  • RISK FACTORS FOR THE DEVELOPMENT OF COMPLICATIONS OF ILEAL POUCH IN PATIENTS WITH ULCERATIVE COLITIS
    S. I. Achkasov, O. I. Sushkov, A. E. Kulikov, Sh. A. Binnatli, M. A. Nagudov, A. V. Vardanyan
    Koloproktologia.2020; 19(1): 51.     CrossRef
  • A Common Complication After an Ileal Pouch-Anal Anastomosis With a Loop Ileostomy in Patients With Ulcerative Colitis: Small Bowel Obstruction
    Chang-Nam Kim
    Annals of Coloproctology.2018; 34(2): 57.     CrossRef
  • Elevated risk of stoma outlet obstruction following colorectal surgery in patients undergoing ileal pouch–anal anastomosis: a retrospective cohort study
    Satoshi Okada, Keisuke Hata, Shigenobu Emoto, Koji Murono, Manabu Kaneko, Kazuhito Sasaki, Kensuke Otani, Takeshi Nishikawa, Toshiaki Tanaka, Kazushige Kawai, Hiroaki Nozawa
    Surgery Today.2018; 48(12): 1060.     CrossRef
Risk Factors of Early Postoperative Small Bowel Obstruction Following a Proctectomy for Rectal Cancer
Jin Yong Shin
J Korean Soc Coloproctol. 2011;27(6):315-321.   Published online December 31, 2011
DOI: https://doi.org/10.3393/jksc.2011.27.6.315
  • 4,088 View
  • 41 Download
  • 5 Citations
AbstractAbstract PDF
Purpose

Postoperative small bowel obstruction is a common and serious complication following a proctectomy, and early postoperative small bowel obstruction (EPSBO) leads to longer hospital stays, delays chemotherapy in advanced cases, and may be a contributor to mortality. The goal of this study is to identify the risk factors of EPSBO after a proctectomy for rectal cancer, thereby seeking to reduce the incidence of EPSBO.

Methods

Patients (735) who underwent a proctectomy for rectal cancer between March 2005 and February 2010 were entered into this study, and data were collected prospectively. Patients were judged to have EPSBO if, within the first 30 days, they presented symptoms such as nausea, vomiting and abdominal distention lasting for 2 days, and radiologic finding of small bowel obstruction after evidence of return of small bowel motility. The association between EPSBO and patients and surgery-related variables were studied by using univariate and multivariate analyses.

Results

EPSBO developed in 47 cases (6.4%) and was the most frequently occurring complication in the early perioperative period following a proctectomy. The frequency of EPSBO according to operative variables shows that EPSBO developed in 3.0% of the patients who underwent laparoscopic surgery (LS) compared with 8.4% of the patients who underwent open surgery (OS) (P = 0.004). OS (odds ratio [OR], 2.5) and a previous laparotomy (OR, 2.3) were independent risk factors for the development of EPSBO after a proctectomy for rectal cancer.

Conclusion

EPSBO is more likely to occur in patients who undergo OS or who have had a previous laparotomy. LS may be considered as a surgical procedure that can reduce the risk of EPSBO in patients undergoing a proctectomy for rectal cancer.

Citations

Citations to this article as recorded by  
  • Median and medial umbilical ligament repositioning for prevention of pelviperineal complications following abdominoperineal resection—a case series and novel technique
    Anand Thomas, Subi TS, Teena Sleeba, Abhijith Antony, Naveen George
    Langenbeck's Archives of Surgery.2024;[Epub]     CrossRef
  • Establishing and clinically validating a machine learning model for predicting unplanned reoperation risk in colorectal cancer
    Li-Qun Cai, Da-Qing Yang, Rong-Jian Wang, He Huang, Yi-Xiong Shi
    World Journal of Gastroenterology.2024; 30(23): 2991.     CrossRef
  • Optimized machine learning model for predicting unplanned reoperation after rectal cancer anterior resection
    Yang Su, Yanqi Li, Wangshuo Yang, Xuelai Luo, Lisheng Chen
    European Journal of Surgical Oncology.2024; 50(12): 108703.     CrossRef
  • Omental Pedicle Flap Does Not Decrease the Incidence of Bowel Obstruction after Abdominoperineal Resection
    Kunal Kochar, Slawomir Marecik, Leela M. Prasad, John Park
    The American Surgeon™.2016; 82(11): 328.     CrossRef
  • Early Postoperative Small Bowel Obstruction is an Independent Risk Factor for Subsequent Adhesive Small Bowel Obstruction in Patients Undergoing Open Colectomy
    Soo Young Lee, Kyu Joo Park, Seung‐Bum Ryoo, Heung‐Kwon Oh, Eun Kyung Choe, Seung Chul Heo
    World Journal of Surgery.2014; 38(11): 3007.     CrossRef
Case Report
A Case of Small Bowel Obstruction Due to a Paracecal Hernia
Eun-Jung Jang, Seung Hyun Cho, Dae-Dong Kim
J Korean Soc Coloproctol. 2011;27(1):41-43.   Published online February 28, 2011
DOI: https://doi.org/10.3393/jksc.2011.27.1.41
  • 4,524 View
  • 31 Download
  • 25 Citations
AbstractAbstract PDF

Internal hernias are rare causes of small bowel obstruction, and one such internal hernia is the paracecal hernia. We report a case of a small bowel obstruction related to a paracecal hernia in which a preoperative diagnosis was made on computed tomography. A laparotomy was performed for definitive diagnosis and treatment. The surgery achieved a good outcome.

Citations

Citations to this article as recorded by  
  • Surgical Management of Pericaecal Hernia in a Virgin Abdomen
    Jia Ling Ong, Wei Chuan Tan, Kien Fatt Sean Lee, Kuan Yuen Yeong, Choon Sheong Seow
    Cureus.2024;[Epub]     CrossRef
  • Internal Hernia Through a Congenital Defect in Broad Ligament: A Rare and Elusive Cause of Intestinal Obstruction
    Partha Nandi, Sudhir Jain, Akhil Kainth, Shivani Atri
    Cureus.2022;[Epub]     CrossRef
  • Ruptured Ovarian Cyst Masking Diagnosis of Hernia Through Broad Ligament of Uterus: A Case Report
    Pankaj Agrawal, John T. Grab, Harold R. Howe, Kimberly Cross
    Journal of Investigative Medicine High Impact Case Reports.2022;[Epub]     CrossRef
  • “PRIMARY INTERNAL HERNIA IN ADULT: A RARE CASE OF ACUTE ABDOMEN”.
    Pooja Pandey, Abhishek Ghosh, Abhishek Ranjan, Shyamendra Pratap Sharma
    INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH.2022; : 60.     CrossRef
  • Uncommon presentation of small bowel pericaecal hernia in an octogenarian
    Balakrishnan Gurumurthi, William Luffman, Mutee Rehman, Taher Fatayer, Abhiram Sharma
    ANZ Journal of Surgery.2021; 91(3): 467.     CrossRef
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    Anshini Jain, Suat Chin Ng, Nicholas Savage, Daniel Lamanna, Satish Warrier, Phil Smart
    ANZ Journal of Surgery.2021;[Epub]     CrossRef
  • Laparoscopic management of a small bowel obstruction caused by an unusual pericecal hernia: Case report
    Abdullah J. AlShehri, Mohannad A. Alsofyani, Bander Al Omeyr, Marwan Amin Abufara, Ali Mohammed Alzahrani, Rami Abdulrahman Sairafi
    International Journal of Surgery Case Reports.2021; 81: 105825.     CrossRef
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    Mahmoud Al-Ardah, Heena Sisodia, Hannah Rottenburg, Michael Clarke
    Journal of Surgical Case Reports.2021;[Epub]     CrossRef
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    Sung Il Kang
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    Shingo Ito, Ryohei Takeda, Ritsuo Kokubo, Yoshio Sakai, Hirokazu Matsuzawa, Kiichi Sugimoto, Makoto Takahashi, Yutaka Kojima, Michitoshi Goto, Yuichi Tomiki, Kazuhiro Sakamoto
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    Sibabrata Kar, Vandana Mohapatra, Pratap Kumar Rath
    Case Reports in Surgery.2016; 2016: 1.     CrossRef
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    Lal Mani Singh, Vinod Yedalwar
    Journal of Evolution of Medical and Dental Sciences.2014; 3(20): 5509.     CrossRef
  • Right salpingo-ovarian and distal ileal entrapment within a paracaecal hernia presenting as acute appendicits
    A. Dhillon, S.G. Farid, S. Dixon, J. Evans
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    Namita A. Sharma, Alok Sharma, Rajendra S. Garud
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    Masako SUYAMA, Masamichi YASUNO, Hidenori TAKAHASHI, Tatsuro WAKAYAMA
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  • Internal Herniation Due to Appendix Vermiformis Rotation: A Rare Case of an Acute Abdomen
    Mehmet Erikoğlu, Mehmet Aykut Yıldırım
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Original Article
Predictive Factor for Surgical Indication in Postoperative Adhesive Small Bowel Obstruction.
Kang, Ji Woong , Nam, Jung Kwang , Kim, Byung Seok , Moon, Duk Jin
J Korean Soc Coloproctol. 2010;26(3):186-189.
DOI: https://doi.org/10.3393/jksc.2010.26.3.186
  • 1,574 View
  • 18 Download
AbstractAbstract PDF
PURPOSE
There is a long-standing debate about whether postoperative adhesive small bowel obstruction (SBO) is best managed operatively or nonoperatively. The aim of this study is to define predictive factors for surgical indication in the treatment of an adhesive SBO.
METHODS
Medical records and laboratory data of 211 patients who had a SBO after a laparotomy from January 2000 to December 2008 were reviewed retrospectively. The patients were divided into two groups according to the modality of SBO treatment: operatively and nonoperatively. The laboratory data and clinical parameters were compared between the two groups and a statistical analysis was performed.
RESULTS
A Mann-Whitney analysis revealed previous SBO history, amylase, erythrocyte sedimentation rate (ESR), creatine phosphokinase, drainage amount via a Levin tube to be significant factors associated with surgical management. A multivariate analysis showed drainage amount via a Levin tube of 500 mL/day or greater (P=0.007), amylase of 90 IU/L or greater (P=0.04), and ESR of 11 mm/hr or greater (P=0.03) to be independent predictive factors for surgery.
CONCLUSION
Surgical management should be considered among adhesive SBO patients with elevated amylase (> or =90 IU/L) and ESR (> or =11 mm/hr) and with large drainage amount through the Levin tube (> or =500 mL/day).
Case Report
Intestinal Obstruction Aggravated by Colonoscopy: A Case Report.
Kim, Hae Jung , Lee, In Tak , Yok, Eu Gon , Lee, So Jin , Lee, Suk Hee , Kim, Do Sun , Lee, Du Han
J Korean Soc Coloproctol. 2009;25(1):56-58.
DOI: https://doi.org/10.3393/jksc.2009.25.1.56
  • 1,750 View
  • 6 Download
  • 1 Citations
AbstractAbstract PDF
Colonoscopy is a frequently performed procedure used for colorectal cancer screening. Most frequent complication is colonic perforation and bleeding. Other visceral injuries are very rare, but injuries to the spleen and liver have been described. We report on 66-yr-old female who presented with abdominal pain after uneventful colonoscopy. Abdominal CT scan revealed a band at previous hysterectomy site and dilated small bowel suggesting strangulated loop. A broad based knowledge of the different complication is necessary to decrease the risk of associated morbidity and mortality.

Citations

Citations to this article as recorded by  
  • Severe ileus after colonoscopy in a patient on peritoneal dialysis
    Sang Un Kim, Su Hee Kim, So Yoon Hwang, Ryang Hi Kim, Ji Young Choi, Jang Hee Cho, Chan Duck Kim, Yong Lim Kim, Sun Hee Park
    Yeungnam University Journal of Medicine.2017; 34(1): 119.     CrossRef
Original Article
Small Bowel Obstruction in Patients without a Previous History of Abdominal Operation.
Chung, Il Yong , Moon, Sang Hui , Park, Hyung Chul , Park, Kyu Joo
J Korean Soc Coloproctol. 2007;23(1):16-21.
DOI: https://doi.org/10.3393/jksc.2007.23.1.16
  • 1,686 View
  • 12 Download
AbstractAbstract PDF
PURPOSE
Intra-abdominal adhesion related to prior abdominal surgery is the most common cause of small bowel obstruction (SBO). However, there are subsets of patients with SBO without a history of previous operation. We studied the characteristics of these patients.
METHODS
The medical records of 311 patients underwent operations at Seoul National University Hospital between Jan. 1994 and Oct. 2005 were reviewed. A retrospective analysis of the incidence, etiology, diagnostic method, preoperative hospital stay, operative findings and methods, complication rates, postoperative hospital stay, re-admission rate, and reoperation rate of SBO was performed, and the results were compared with those of patients with a history of previous operation.
RESULTS
Among the 311 patients (54.4 +/- 14.7 yr, M:F=1.5:1), 48 patients (15.3%) had no history of operation. The etiologies of SBO without a history of operation were malignancy (23.0%), bezoar (14.5%), adhesion (10.4%), Crohn's disease (10.4%), tuberculosis (8.3%), and appendicitis (8.3%). SBO without prior abdominal surgery showed a longer preoperative hospital stay, which was not statistically significant. The accuracies of CT and small bowel series among patients without a history of operation were 68.4% and 54.5%, respectively. SBO without prior abdominal surgery showed a lower complication rate (8.3% vs. 26.6%, P=0.006) and shorter postoperative hospital stays (12.7 +/- 6.9 days vs. 16.1 +/- 10.4 days, P=0.032).
CONCLUSIONS
Among the patients who underwent an operation for SBO, 15.3% had no history of previous operation. The most common cause of SBO without a history of operation was malignancy. SBO without a history of operation showed a lower complication rate and a shorter postoperative hospital stay compared with SBO with a history of operation.
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