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Small-bowel obstruction
November 08, 2005Obstruction of the intestines due to adhesions resulting from previous abdominal surgery is painful, results in vomiting and dehydration and requires urgent medical and often surgical intervention.
Typical management requires placement of a nasogastric tube (a small plastic tube inserted to drain the contents of the stomach and its gastric juices), intravenous rehydration and prolonged observation to see if the obstruction will spontaneously resolve. Often surgical intervention is necessary to relieve the obstruction. Although the practice of giving patients nothing by mouth might appear intuitive, there is little evidence to support it.
In this randomized controlled trial, Chen and coauthors assigned consecutive patients with partial small-bowel obstruction to receive either standard care and nothing by mouth (control group) or standard care plus oral therapy with a laxative, a digestant and a defoaming agent (intervention group).
Compared with patients in the control group, patients receiving oral therapy were more likely to have successful treatment without surgery (91% v. 76%); relative risk of avoiding surgery 1.19 (95% confidence interval 1.03 to 1.40). They also had shorter lengths of stay in hospital. Follow-up of all patients showed that there were no longer-term adverse events resulting from the new management strategy.
This study has important implications for clinical practice. Although further studies are needed to confirm and further explore these findings, clinicians and surgeons can apply the results to the management of similar patients and expect to see fewer patients requiring surgery and shorter stays in hospital.
Canadian Medical Association Journal
Compared with patients in the control group, patients receiving oral therapy were more likely to have successful treatment without surgery (91% v. 76%); relative risk of avoiding surgery 1.19 (95% confidence interval 1.03 to 1.40). They also had shorter lengths of stay in hospital. Follow-up of all patients showed that there were no longer-term adverse events resulting from the new management strategy.
This study has important implications for clinical practice. Although further studies are needed to confirm and further explore these findings, clinicians and surgeons can apply the results to the management of similar patients and expect to see fewer patients requiring surgery and shorter stays in hospital.
Canadian Medical Association Journal
Bowel Obstruction Current Events and Bowel Obstruction News RSSImplementation of acute care surgery service provides more timely patient care
A new study published in the October issue of the Journal of the American College of Surgeons shows that the establishment of an acute care surgery service can help surgeons at academic medical centers provide more timely care to the growing number of patients who are transferred from the emergency room or smaller hospitals and who require an immediate operation.
Helping Hand of Hybrid Surgery Benefits Colorectal Patients
Despite rapid strides in minimally invasive surgical techniques -- most notably, laparoscopy -- traditional open surgery remains the most common surgical option across the United States for people with diseases of the rectum and colon.
Death rate 70 percent lower at top-rated hospitals: HealthGrades annual hospital quality study
Patients have on average a 70 percent lower chance of dying at the nation's top-rated hospitals compared with the lowest-rated hospitals across 17 procedures and conditions analyzed in the eleventh annual HealthGrades Hospital Quality in America Study, issued today by HealthGrades, the leading independent healthcare ratings organization.
May inflammatory bowel disease mimic gynecological disorders in its clinical presentation
Endometriosis is a condition of unknown etiology in which endometrial tissue occurs at extra-uterine sites, including ovaries, fallopian tubes, and gastrointestinal tract.
A strange case of upper obstructive syndrome
Aorto-duodenal fistulae (ADF) are the most frequent aorto-enteric fistulae (80%) and the most frequent presenting sign of ADF is upper gastrointestinal bleeding (UGI).
Antegrade bowel intussusception can cause recurrent, chronic postoperative intestinal obstruction
Several complications can be seen after pancreatic surgery, most notably bleeding, infections and anastomotic dehiscence. Bowel obstruction can also be seen due to internal hernias or anastomotic strictures. A more unusual etiology for bowel obstruction in this setting is intussusception.
Annual study finds top hospitals have 28 percent lower mortality rate
Patients treated at top-rated hospitals nationwide have nearly a one-third better chance of surviving, on average, than those admitted to all other hospitals, according to a study released today by HealthGrades, the leading independent healthcare ratings company.
Intensity-modulated radiation therapy reduces side effects for cervical cancer
Preliminary results from a University of Pittsburgh study evaluating extended-field intensity-modulated radiation therapy (IMRT) for cervical cancer found that it resulted in significantly reduced side effects and outcomes comparable to standard radiotherapy.
Junk DNA may not be so junky after all
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New vaccine could prevent condition that causes 500,000 infant deaths a year worldwide
In a new study of more than 68,000 infants published in this week's New England Journal of Medicine, the investigational vaccine Rotateq demonstrated that it can safely prevent 98 percent of severe cases of viral diarrhea and vomiting that account for 2 million hospital visits and 500,000 pediatric deaths each year worldwide.
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Small-Bowel Obstruction: CT Features with Plain Film and US correlations by Roberto Di Mizio (Editor), Mariano Scaglione (Editor) Small bowel obstruction is a common but difficult clinical problem in terms of appropriate diagnosis and timely management. In clinical practice, radiologists play a key role in the assessment of small bowel obstruction and can guide physicians toward appropriate and timely management of the many indeterminate cases and situations. However, to understand and connect the pathophysiology to the imaging features remains the most difficult task radiologists face in their clinical activity. The aim of this book is connect pathophysiology to imaging using many illustrations and examples, emphasizing the capabilities and limitations of multidetector computed tomography and its role in the correct management approach to these disorders. Furthermore, the place of allied imaging modalities... |
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The Terapeutic Problems in Bowel Obstruction (Leather Bound) by Owen Wagensteen (Author) BRAND NEW leather bound book accented with gilt! ! Facsimile reproduction of original work. | |
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Bowel Obstruction - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References by ICON Health Publications (Author) In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading." Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing.This book was created for medical professionals, students, and members of the general public who want to conduct medical research using the most advanced tools available and spending the least amount of time doing so. |
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Stents avoid surgery in acute large-bowel obstructions. (Palliation in Colorectal Cancer).(Brief Article): An article from: Internal Medicine News by Bruce Jancin (Author) This digital document is an article from Internal Medicine News, published by International Medical News Group on March 15, 2002. The length of the article is 663 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser. Citation Details Title: Stents avoid surgery in acute large-bowel obstructions. (Palliation in Colorectal Cancer).(Brief Article) Author: Bruce Jancin Publication: Internal Medicine News (Magazine/Journal) Date: March 15, 2002 Publisher: International Medical News Group Volume: 35 Issue: 6 Page: 26(1) Article Type: Brief Article Distributed by Thomson... | |
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