Laparoscopic management of acute adhesive small bowel obstruction has been shown to be feasible and advantageous. However, widespread acceptance and application is still not observed. We describe the case report of a 58-year-old male who presented with signs and symptoms of small bowel obstruction status twenty years after two consecutive open surgeries for complicated acute appendicitis. The patient underwent successfully a laparoscopic band lysis after failure of conservative management. This is the first report of laparoscopic management of adhesive small bowel obstruction in Cameroon. Laparoscopic adhesiolysis of acute adhesive small bowel obstruction is feasible and safe by skilled surgeons in selected patients even in developing countries.
The aim of our study was to determine whether Urografin has the potential to offer surgeons a way of differentiating complete from partial small bowel obstruction and whether partial small bowel obstruction can be treated nonoperatively. Altogether 116 patients who had postoperative small bowel obst …
Juan D Hernandez, MD, Ricardo Nassar, MD. Hospital Universitario Fundacion Santa Fe de Bogota and Universidad de los Andes.. Introduction: In adhesive small bowel obstruction, surgical management is traditionally used only when medical, non-operative treatment has failed. The manipulation of dilated, ischemic bowel loops during small bowel obstruction is difficult and not free of complications under any approach. On occasions, other conditions force surgeons to operate since bowel viability is at risk. Authors present their experience using a minimally invasive approach in conditions causing acute small bowel obstruction.. Methods and procedures: After confirmation of a small bowel obstruction requiring surgical treatment, patients were informed of the options including laparoscopic approach. After consentment, patients underwent a laparoscopic exploration to assess the feasibility of competing the operation with this technique. According to preoperative diagnosis and intraoperative findings, a ...
Bowel obstruction is a condition which has been known for many years. As time goes by, the problem is still often encountered at surgical emergency rooms. More than 20% of emergency surgical interventions are performed because of symptoms of digestive tract obstruction with the disease mostly situated in the small bowel. Rates of causative factors of the disease have changed over recent years and there have been increasingly more cases of small bowel obstruction caused by peritoneal adhesions, i.e., adhesive small bowel obstruction (ASBO).The aim of the study to analyse the reasons and incidence of adhesive small bowel obstruction during two periods of time (1990-1995 and 2005-2010).Material and methods. We performed a retrospective analysis of medical records of patients hospitalized at the 1st Department of General Surgery and Surgical Oncology of the Provincial Polyclinic Hospital in Płock between 1990 and 1995. The outcomes were compared with another period of 2005-2010.Results. We found ...
PubMed journal article: CT findings in patients with small bowel obstruction due to phytobezoar. Download Prime PubMed App to iPhone, iPad, or Android
Abdominal cocoon is a rare cause of intestinal obstruction. The abdominal cocoon is probably a developmental abnormality, largely asymptomatic, and is found incidentally at laparotomy or autopsy. Pre-operative diagnosis cannot be often made correctly. This rare entity of intestinal obstruction has been described in the whole literature as a thick fibrotic sac covering the small bowel partially or completely. The etiology of abdominal cocoon is unknown and most often it is found in adolescent girls from tropical or subtropical countries. Complete recovery is generally expected after the removal of the membrane surgically. This paper reports a male patient who has had intestinal obstruction symptoms and has per-operatively been diagnosed as abdominal cocoon.
Review question. We reviewed the evidence about the effectiveness and safety of different treatments for distal intestinal obstruction syndrome (DIOS) in children and adults with cystic fibrosis.. Background. Cystic fibrosis is a common, life-limiting, inherited disease. One of the main features of cystic fibrosis is the thick, sticky mucus produced by many organs including the lungs, pancreas and intestine. DIOS occurs when mucus in the intestine combines with faeces and builds up to produce a mass. This mass can partially or completely block the intestine and cause symptoms such as vomiting, severe abdominal pain and a swollen stomach (abdominal distension). Once a diagnosis of DIOS has been made, the goal of therapy is to relieve the complete or partial blockage and ultimately prevent the need for any surgical intervention.. Search date. The evidence is current to: 10 June 2018.. Trial characteristics. The review included one trial with 20 people with cystic fibrosis who were aged between 7.1 ...
Our search returned 1840 results, from which 28 trials (5191 patients) were included in our meta-analysis. The risks of systematic and random errors were low. No trials reported data for the effect of oxidised regenerated cellulose or polyethylene glycol on reoperations for adhesive small bowel obstruction. Oxidised regenerated cellulose reduced the incidence of adhesions (relative risk [RR] 0·51, 95% CI 0·31-0·86). Some evidence suggests that hyaluronate carboxymethylcellulose reduces the incidence of reoperations for adhesive small bowel obstruction (RR 0·49, 95% CI 0·28-0·88). For icodextrin, reoperation for adhesive small bowel obstruction did not differ significantly between groups (RR 0·33, 95% CI 0·03-3·11). No barriers were associated with an increase in serious adverse events ...
Bowel obstruction should be considered as a potential surgical emergency when a patient presents with acute abdominal pain. It occurs when the normal flow of intestinal contents is interrupted. The most common causes are adhesions followed by tumors and hernias. Other causes include strictures, intussuseption, volvulus, Chrohns disease, and gallstones. Obstruction is classified as small bowel obstruction (SBO) or large bowel obstruction (LBO) based on the level of obstruction. LBO is more commonly caused by malignancy and will not be discussed in detail in this module.. Small bowel obstruction begins when the normal luminal flow of intestinal contents is interrupted and the small intestine proximal to the obstruction dilates. Secretions are prevented from passing distally. As time progresses, the distension leads to nausea and vomiting and inability to take oral intake. Bacteria may ferment in the proximal intestine and cause feculent emesis. The bowel wall becomes more and more edematous as ...
The results of complex surgical treatment of 202 patients with acute intestinal obstruction were analyzed. Established, that growth of enteregia of intestine the value of endogenous intoxication increased.
The optimal timing of surgery after colonic stenting has not been established. In the European guidelines, the suggested time interval between colonic stenting and surgery is 5-10 days when colonic stenting is used as a bridge to elective surgery in patients with potentially curable left-sided colon cancer [5]. The time interval in the guideline was determined based on a few studies with different qualities. For this reason, the recommendation on the time interval is weak and the level of evidence is low. In a meta-analysis comparing colonic stenting as bridge to surgery and emergency surgery for left-sided colorectal cancer obstruction, surgery was generally performed after a median 10 days after colonic stenting [6]. This study, however, did not aim to determine the optimal time interval between colonic stenting and surgery. Moreover, the median 10 days resulted from statistical analysis of the data from the included studies. A retrospective study concluded that a duration of 7-9 days after ...
Gastrointestinal obstruction is a very common condition that occurs frequently in dogs and cats. Young dogs are generally at a higher risk because they are not picky about what they eat. An intestinal obstruction is simply a blockage of the flow of food material in the gastrointestinal tract. The obstruction can be partial or complete, may occur in any area of the gastrointestinal tract and can be caused by many different reasons. If the obstruction occurs in the stomach, then you will see vomiting, dehydration, lethargy and weight loss. Small intestinal obstruction will also cause these symptoms; however, damage to the intestinal lining can result in death of the bowel and potentially toxemia (toxins in the blood). There are many things that can lead to gastrointestinal obstruction, including tumors, inflammation of the gastrointestinal tract, gastric outflow obstruction because of thickening, twisting of the gut, intussusceptions (telescoping of the intestine) and, most commonly, foreign ...
Much debate surrounds the one-stage surgical management of acute left colon obstruction. Many surgeons are still reluctant to perform primary anastomosis in unprepared bowel fearing the risk of anastomotic dehiscence. Although intraoperative lavage and subtotal colectomy have recently proved effective for preventing fecal loading, both of these procedures have drawbacks and the search for additional alternative surgical procedures continues. We conducted an experimental study to examine a new one-stage operation, consisting of the interposition of a jejunal segment to the resection site of the colon, to manage acute left colon obstruction. The colons of 20 domestic pigs were obstructed, and 2 days later, segmental resection and either primary colo-colonic anastomosis or interposition of a jejunal segment was performed. Autopsies were done 6 weeks after the operations and the anastomotic regions were subjected to bursting pressure analysis. The operating time was longer in the interposition group at 49
Cappell, MS, Batke, M. "Mechanical obstruction of the small bowel and colon". Med Clin N Am. vol. 92. 2008. pp. 575-97. Godfrey, EM, Addley, HC, Shaw, AS. "The use of computed tomography in the detection and characterisation of large bowel obstruction". N Z Med J. vol. 30. 2009. pp. 57-73. Halabi, WJ, Jafari, MD, Kang, CY. "Colonic volvulus in the United States: trends, outcomes, and predictors of mortality". Annals of surgery. vol. 259. 2014. pp. 293-301. Harrison, ME, Anderson, MA, Appalaneni, V. "The role of endoscopy in the management of patients with known and suspected colonic obstruction and pseudo-obstruction". Gastrointestinal endoscopy. vol. 71. 2010 Apr 30. pp. 669-79. Lepage-Saucier, M, Tang, A, Billiard, JS, Murphy-Lavallee, J, Lepanto, L. "Small and large bowel volvulus: clues to early recognition and complications". Eur J Radiol. vol. 74. 2010. pp. 60-66. Maddah, G, Kazemzadeh, GH, Abdollahi, A. "Management of sigmoid volvulus: Options and prognosis". Journal of the College of ...
Ελληνική Γαστροεντερολογική Εταιρία. Annals of Gastroenterology.Τμήμα περιοδικού.Επιστημονικό άρθρο.Άρθρο.2007 . Creators: Pilichos, C., Bourgeon, A., Fotiadis, C., Baque, P, Benchimol, D., Givry, A., Rahili, A., Bernard, JL.Background and Aim: Colonic stenting is a novel and privileged therapeutic option for malignant obstructions of the large bowel, especially as a bridging procedure to elective surgery. The aim of this retrospective study was to compare the efficacy of the traditional surgical approach with stent placement in the management of obstructing colorectal tumours. Patients and Methods: Thirty-three patients with malignant colonic obstruction were retrospectively studied. Of them, 17 underwent a diversion colostomy (group I), while 16 were treated with SEMS (group II). Early outcome, late outcome and duration of hospitalisation were evaluated. For statistical analysis chi-square and Student.s t-test were used
Mo1626 The Newly Nitinol Conformable Self-Expandable Metal Stents for Malignant Colonic Obstruction: a Pilot Experience As Bridge to Surgery Treatment in a Tertiary Referral ...
Bowel obstruction, also known as intestinal obstruction, is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. Either the small bowel or large bowel may be affected. Signs and symptoms include abdominal pain, vomiting, bloating and not passing gas. Mechanical obstruction is the cause of about 5 to 15% of cases of severe abdominal pain of sudden onset requiring admission to hospital. Causes of bowel obstruction include adhesions, hernias, volvulus, endometriosis, inflammatory bowel disease, appendicitis, tumors, diverticulitis, ischemic bowel, tuberculosis and intussusception. Small bowel obstructions are most often due to adhesions and hernias while large bowel obstructions are most often due to tumors and volvulus. The diagnosis may be made on plain X-rays; however, CT scan is more accurate. Ultrasound or MRI may help in the diagnosis of children or pregnant women. The condition may be treated conservatively or with surgery. ...
Post written by Alberto Arezzo, MD, from the Department of Surgical Sciences, University of Torino, Turin, Italy. Twenty years after the first description of the technique, the debate is still open on the role of self-expandable metallic stent (SEMS) placement as a bridge to elective surgery for symptomatic left-sided malignant colonic obstruction. The focus of…
Intestinal obstruction is a common surgical condition. It may be small bowel or large bowel obstruction. Small gut volvulus is rare in adults and usually presents with acute intestinal obstruction. We here report two cases with primary small bowel volvulus who presented with acute intestinal obstruction. The gangrenous gut was resected and end to end anastomosis done at laparotomy.. ...
The latest American Journal of Surgery examines the prevalence and risk factors of mortality after operation for adhesive postoperative small bowel obstruction.. ...
Malaria remains a major public health problem in most tropical countries. It occasionally presents with both typical and atypical signs and symptoms. Gastrointestinal manifestations are common in malaria endemic areas but intestinal obstruction as a complication is extremely rare. We present the case of a 42-year-old black African man who presented with signs and symptoms of intestinal obstruction and was diagnosed as having Plasmodium falciparum malaria. He was successfully treated with both parenteral and orally administered antimalarial medication and the intestinal obstruction subsequently resolved. With intestinal obstruction being an important cause of morbidity and mortality, we report this case to highlight this rare complication of malaria and therefore increase physicians awareness and prompt diagnosis and management.
Metastatic laryngeal cancer to the small bowel is extremely rare. Management of small bowel obstruction used to constitute a relative contraindication for the use of laparoscopic modality. We are reporting a case of an elderly man known to have laryngeal cancer who presented with small bowel obstruction due to metastatic deposit to the small bowel. The condition was successfully treated by laparoscopic assisted approach. A review of the natural history of advanced laryngeal cancer, common and uncommon sites of metastasis, and the rare presentation as small bowel obstruction is illustrated in this review.
In the management of small bowel obstructions, a commonly quoted surgical aphorism is: "never let the sun rise or set on small-bowel obstruction"[22] because about 5.5%[22] of small bowel obstructions are ultimately fatal if treatment is delayed. Improvements in radiological imaging of small bowel obstructions allow for confident distinction between simple obstructions, that can be treated conservatively, and obstructions that are surgical emergencies (volvulus, closed-loop obstructions, ischemic bowel, incarcerated hernias, etc.).[2] A small flexible tube (nasogastric tube) may be inserted through the nose into the stomach to help decompress the dilated bowel. This tube is uncomfortable but relieves the abdominal cramps, distention, and vomiting. Intravenous therapy is utilized and the urine output is monitored with a catheter in the bladder.[23] Most people with SBO are initially managed conservatively because in many cases, the bowel will open up. Some adhesions loosen up and the obstruction ...
For patients with small bowel obstruction that have never had surgery before, considered a virgin abdomen, surgery is indicated since there will be an underlying cause(adhesions, small bowel tumor, foreign body) found which will require fixing to relieve the obstruction and prevent its recurrence.Crohns disease may cause partial to complete small bowel obstruction and may improve with medical management. I approach small bowel obstructions laparoscopically since I am generally successful in resolving the condition without a laparotomy(open surgery) incision. Large bowel obstruction is generally caused by carcinoma, a volvulus (twist) or a stricture of long-standing diverticulitis. If a bowel prep can be performed prior to emergency surgery and the risk of infection and leak is diminished(volvulus is a complete obstruction and needs emergency management ). Surgery for diverticulitis and colon cancer is generally laparoscopic,only using a hand-assisted port for very complex problems.. ...
Intestinal obstruction due to gallstones is a relatively rare condition. In 1890, Courvoisier1 reported 131 cases, and in 1917 Wagner2 found reports of 333 case
A malignant obstruction in end-stage colon cancer can occur from tumors pressing on the intestines from within or from outside of the digestive tract.
INTRODUCTION- acute intestinal obstruction is one of the commonest surgical emergencies in all age groups with similar mode of presentation but a variety of causes.The age old dictum of " never let the sun set or rise in small bowel obstruction" holds good to reduce the incidence of strangulation. Success in treating intestinal obstruction depends on the cause and also on skillful management and appropriate treatment of pathological effects of intestinal obstruction. OBJECTIVES- to study the common causes of intestinal obstruction faced by a general surgeon and to study methods of early diagnosis and intervention for better outcome. MATERIALS AND METHODS-- Cases admitted in the department of General surgery, Sri Venkateswara Medical College and SVRR hospital between july 2009 to november 2011 forms the material of the study. Investigations used in this study along with clinical examination are biochemical, radiological and others. All patients in whom a diagnosis of intestinal obstruction was ...
BACKGROUND: Predicting the clinical course in adhesional small bowel obstruction is difficult. There are no validated clinical or radiologic features that allow early identification of patients likely to require surgical intervention. METHODS: We conducted a retrospective review of 100 patients consecutively admitted to a tertiary level teaching hospital over a 3-year period (2002-2004) who had acute adhesional small bowel obstruction and underwent computed tomography (CT). The primary outcomes that we assessed were conservative management or the need for surgical intervention. We investigated time to physiologic gastrointestinal function recovery as a secondary outcome. We examined independent predictors of surgical intervention in a bivariate analysis using a stepwise logistic regression analysis. RESULTS: Of the 100 patients investigated, we excluded 12. Of the 88 remaining patients, 58 (66%) were managed conservatively and 30 (34%) underwent surgery. Peritoneal fluid detected on a CT scan (n ...
Small bowel obstruction surgery recovery - I had a small bowel obstruction surgery that was done by a general surgeon. What type of specialist /doctor do I see after for consultation? Surgeon and PCP. It is important for you to follow up with the surgeon who operated on you because he/she will be able to recognize if your bowels have returned to normal function. It will also be important for you to see your primary care doctor who will have the greatest continuity of care with you. In the event of a re-obstruction, be sure to return to the same surgeon. They will know your anatomy details.
The term ileus is now most often used to imply non-mechanical intestinal obstruction. Learn about Intestinal Obstruction and Ileus and treatment of Intestinal Obstruction.
In the present study, to investigate diagnosis and treatment of strangulated intestinal obstruction caused by mesentery vein thrombosis on account of portal hypertension, the data in twelve patients with this disease from 1998 to 2008 were analyzed. All patients presented abdominal pain and vomiting and were confirmed strangulated intestinal obstruction caused by mesentery thrombosis with operation. In this group, nine patients underwent part of small intestine excision, and three patients underwent open-closed operation because of the whole small intestine necrosis caused by intensive mesentery thrombosis. Five patients died after operation. The diagnosis of strangulated intestinal obstruction caused by mesentery thrombosis was difficult because of the slow disease processes and severe outcomes. It is necessary to take some measures to get over the dangers duration after operation.
Adult large bowel obstruction is an infrequent cause of acute obstruction. In Africa and India it is caused commonly by sigmoid volvulus [1]. In developing countries tuberculous stricture may also be a likely cause [2]. Transverse colon obstruction is relatively uncommon. Carcinoma of the transverse colon accounts for 10 % of all colorectal cancer [3]. When an obstructive lesion is seen in an adult, ruling out malignancy is of top priority but the biopsy gives the surprise. Such a case is reported. Case. 42 years old lady had presented with abdominal fullness and discomfort of 15 days duration. She was passing flatus infrequently and passing small quantity of stool daily. But in the last 2 days before her presentation she was neither passing flatus nor stool. She did not give any history of similar complaints or of undergoing any surgery in the past. There was no history of definite pain or fever. She was having her period regularly. On examination she was in good general health. There was mild ...
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List of 330 causes for Lump and Partial colon obstruction, alternative diagnoses, rare causes, misdiagnoses, patient stories, and much more.
Bloating of the abdomen and loss of appetite are very common intestinal obstruction symptoms. If the obstruction is in the small intestine, nausea and vomiting may be present. Constipation results from total obstruction, but
Inflammatory acute abdomen is generally caused by an infection such as appendicitis, hepatitis, pelvic inflammatory disease, pancreatitis or cholecystitis. Other problems that may lead to inflammatory pain that is acute in nature, which may include perforation of a peptic ulcer or complications of inflammatory bowel disease such as ulcerative colitis or Crohns disease.. Mechanical causes of acute abdomen may be brought on by bowel obstructions or vascular conditions. Small bowel obstructions secondary to adhesions caused by surgeries are somewhat common, as are large bowel obstructions caused by colorectal cancers, fecal impaction, hernias and other conditions associated with this area of the body. Occlusive intestinal ischemia, which is generally caused by thromboembolism of the superior mesenteric artery, may also result in acute abdomen.. What are the causes of chronic abdominal pain?. If your abdominal pain is severe and chronic it is important to be looked at by a Michigan pain management ...
In dogs caused experimental strangulation obstruction by ligation of the upper small intestine together with the mesentery measuring 80 cm in length, adrenal venous blood was observed for the secretion rate of adrenaline and noradrenaline by the fluorimetric method. Increase of adrenal medullary secretion was not induced by the continued strangulation alone. However, when the strangulation was released three hours after the onset, the secretion rate of adrenaline and noradrenaline increased rapidly. When 250 mg of kanamycin was injected into the strangulated intestinal loop and the obstruction was released three hours later, the increase of adrenal medullary secretion was slight. When the strangulated intestinal loop was resected and anastomosed three hours after the onset of obstruction, the adrenal medullary secretion showed no increase. When strangulation was released after resection of the greater and lesser splanchnic nerves on the side wherefrom the adrenal venous blood was drawn, any ...
Peritoneal encapsulation is a very rare condition characterised by what looks to be an accessory peritoneal membrane covering all or part of the small bowels [1]. This is attached to the ascending and descending colon laterally, the transverse colon superiorly and the posterior surface of the parietal peritoneum inferiorly. It is believed to be caused by mal-rotation of the bowel during the 12th week of gestation [1], this causes the formation of an accessory sac from the peritoneum covering the umbilicus. The membrane may cover the entire or part of the small bowel from the duodeno-jejunal junction down to the ileo-colic junction [2].. The two commonest clinical presentations are: acute small bowel obstruction or incidental diagnosis during laparotomy for another condition [4], however, many cases are incidental findings at autopsy. Some patients may have episodes of intermittent colicky abdominal pain or episodes or sub-acute small bowel obstruction, prior to a definitive diagnosis,. Diagnosis ...
Exploratory laparotomy, release of small bowel obstruction, and repair of periumbilical hernia. Acute small bowel obstruction and incarcerated umbilical Hernia.
Symptoms of intestinal obstruction - Intestinal Obstruction - Symptoms, Diagnosis, Treatment and.... Bowtrol Probiotic improve gastrointestinal function & intestinal good bacterial microbial balance.
Is Intestinal Obstruction a common side effect of Solupred? View Intestinal Obstruction Solupred side effect risks. Female, 81 years of age, was diagnosed with asthma, respiratory distress, hypercholesterolaemia and took Solupred . Patient was hospitalized.
Bowel obstruction: Find the most comprehensive real-world symptom and treatment data on bowel obstruction at PatientsLikeMe. 267 patients with bowel obstruction experience fatigue, depressed mood, anxious mood, Pain, and insomnia and use Gabapentin, Neuromuscular Electrical Stimulation, Tramadol, Alprazolam, and Buspirone to treat their bowel obstruction and its symptoms.
were compared by means of χ2 or Fishers exact test. The In addition, interim analysis recorded no difference in the Kaplan-Meier method was used for survival analysis, with primary outcome of the study, which was global health sta-tus. Details of the study design and short-term outcomes comparison between stent and emergency surgery groups have been published previously6. Patients randomized to using the log rank test. In addition, a subanalysis was per- emergency surgery underwent resection of the primary formed of all patients who had a stent-related perfora- tumour, with either primary anastomosis, temporary stoma tion within the stent group. Inclusion in this subgroup was or definitive stoma, at the discretion of the surgeon. Those based on the presence of tumour perforation on patholog- randomized to stent placement received either an enteral ical examination; this included both clinical and subclini- Wallstent™ (diameter 22 mm; Boston Scientific, Marlbor- cal perforations. Estimated ...
An elderly man with recurrent bouts of large bowel obstruction secondary to a sigmoid volvulus. The operative views show a redundant loop of sigmoid colon. This has undergone numerous episodes of torsion - as judged from the fibrous bands of scar tissue seen running up the mesentery ...
Bowel obstruction occurs when the normal flow of intraluminal contents is interrupted. Obstruction can be functional (due to abnormal intestinal physiology) or due to a mechanical obstruction, which can be acute or chronic. Advanced small bowel obstr
A 53 year old female diagnosed with long term resistant schizophrenia, ischaemic heart disease and hypertension was treated with 700 mg/day of clozapine. Five months after commencing treatment, she complained of acute onset colicky abdominal pain and nausea with constipation of one days duration. Suspecting intestinal obstruction, she was referred from a psychiatry unit to the casualty ward. On examination, she had a distended abdomen and tenderness. No abdominal masses were detected. A stool softener and lactulose was given. However, five hours later, she died. Autopsy revealed a grossly distended intestine extending from the stomach to the rectum. There were solid and liquid faeculent material commencing from the oesophagus through to the rectum. No mechanical obstruction was evident. A sector of the ileum showed an area of patchy haemorrhage. Histology showed villous atrophy with flattened epithelial cells and fibrosis of the lamina propria. The heart had a few scattered areas of fibrosis. ...
Intestinal Obstruction Symptoms and Treatments in Dogs - Any problem that interferes with the passage of intestinal contents through the GI tract results in a blocked bowel. Dogs experience bowel obstruction more often than cats because they love to chew. This eventually leads them to swallowing non-digestible objects like sticks and stones.
We would like to present two patients with triple localized, synchronous colon tumors who underwent emergency operations for obstruction. The second and third localizations were discovered during the operation.
Introduction:. First reported in 1991, laparoscopic assisted colectomy is increasingly practised world-wide. Abundant evidence exists in the literature suggesting laparoscopic assisted colectomy, when compared with its open counterpart, is associated with more favourable short-term outcomes, better cosmesis, and better patients satisfaction. Moreover, recent reports from large-scale randomized trials support the use of this minimally invasive technique in the treatment of colorectal cancer, a malignant condition common in many parts of the world. However, around 8-29% of patients with colorectal cancer present as acute large bowel obstruction, a condition used to be considered as a contraindication to laparoscopic surgery due to poor exposure and potential hazard of injury to the distended bowel. Thus, most cases of malignant large bowel obstruction mandate an emergency open surgery to relieve the obstruction and resect the tumour, with many patients, especially those with obstructing ...
Five children with atrial isomerism developed intestinal obstruction caused by malrotation of the gut. Other than asplenia, the extracardiac anomalies in these syndromes are rarely regarded as important as the outcome after intestinal surgery is poor. As cardiac treatment improves, early investigation and intervention for intestinal symptoms becomes more important.. ...