surgical management of intestinal obstruction

The most common cancers that cause bowel obstructions are cancers of the colon, stomach, and ovary. and large bowel obstruction. The neoplastic obstruction of distal colon or rectum shows great distension of the colon above the obstacle and chronic and progressive symptoms of constipation with the change of regular bowel function toward constipated bowel function, changes of stool caliber, long-term cathartic use. Also the suspicion of strangulation occlusion, based on continuous and severe abdominal pains, should prompt surgery.The surgical choice for irreducible or strangulated hernia of abdominal wall is very obvious.In the case of high suspicion for digestive malignancy, most frequently in large bowel, surgical intervention should be performed. The symptoms are similar to large bowel obstruction and develop over 3–7 days.Imaging examinations, plain radiography, CT scan should help to exclude mechanical bowel obstruction. The progressive accumulation of gas and fluid in the intestinal lumen allows the increase in the endoluminal pressure to very high values: in the small bowel the pressure can reach 15 cm HElectrolytes composition in blood plasma and digestive secretion.The experimental studies demonstrated the linear connection between bowel obstruction, increase in intraluminal pressure, gut wall distension, changes in blood flow [In the pathological setting, the increase in the intraluminal pressure should develop slowly and should not reach high degree [The intestinal wall distension in the obstructed patients causes increased distensibility of the gut wall that becomes more vulnerable to a further increment of distension. All patients had received adjunctive chemotherapy Several factors may influence the therapeutic choice: the location of the tumor (proximal-distal colon), the degree of colonic distension and the impairment of blood flow of intestinal wall, the involvement of the general conditions of the patient with organ failure, dehydration, hypovolemia, and sepsis.In this scenario, variable and complex, it is very difficult to establish a well-defined and unequivocal line therapy in relation to the surgical procedure to be used. Clinical features, postoperative complications, and survivalLewis and related tumor-associated determinants on ovarian carcinomaRadiation therapy in primary carcinoma of the vaginaWe use cookies to help provide and enhance our service and tailor content and ads.

Abdominal distension should be considered the most frequent physical sign of intestinal obstruction [The degree of abdominal distension varies depending upon the site of the obstacle or the extension of the obstructed bowel. CT scan usually can identify the specific site of obstruction clarifying the transition point of distended and empty loops and also the complete intestinal occlusion.

In fact, the gut distension causes the inhibitory reflex of intestinal motility by receptors of longitudinal musculature of the bowel.The accumulation of fluid and gas is accompanied by altered functions of intestinal mucosa. Clinical Features, Postoperative Complications, and Survival DANIEL L. ... were reviewed retrospectively searching for patients who underwent surgical correction of intestinal obstruction. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.

Your message goes here Medical Center, Durham, North Carolina 27710 U.S.A.Division of Biometry, Department of Community and Family Medicine and the Health Services Research Field Program, V. A. This study supports surgical resection over surgical bypass to treat obstructive PC, as it offered better OS with fewer complications. Finally, the clinical evolution of the disease is chronic.The results of the therapy of secondary forms are scantly and uncertain; usually, the therapy is connected with the treatment of the serious systemic diseases.

Now customize the name of a clipboard to store your clips. On the contrary, there is also strangulation obstruction, usually due to complicated external hernia (abdominal wall) or internal (by congenital defects or postoperative adhesions): in these patients the vascular supply to a strangulated intestinal segment is compromised and consequently intestinal infarction. These evaluations can show some different details. * CORRESPONDING AUTHOR Dr J Sambasiva Rao Associate Professor, Department of General Surgery, Siddhartha Medical college, Vijayawada, Andhra Pradesh. Some measures can be required: the use of a bladder catheter to monitoring urine output, adequate intravenous access, arterial canalization, and CVP monitoring.The purpose of the therapeutic approach is the correction of hypovolemia and electrolytes depletion with volume resuscitation. Indeed, the obstructive syndrome starts with the absence of flatus.