Diagnosis and treatment of acute bowel obstruction
Abstract
Aim. To improve treatment outcomes in patients with acute bowel obstruction. Methods. 1479 patients with bowel obstruction (75.7% - small bowel obstruction, 24.3% - large bowel obstruction) were examined. Patients were treated according to the local treatment protocol, 1003 (68%) patients underwent surgery. Results. The following procedures were performed at the stage of bowel obstruction diagnosis and treatment: conventional adhesiolysis was performed in 425 cases, laparoscopic adhesiolysis - in 425 cases, small bowel resection with further anastomosis - in 151 cases, small bowel resection with ileostomy - in 15 cases, phytobezoar fragmenting - in 56 cases, enterotomy and phytobezoar removal - in 2 cases. In patients with large bowel obstruction the following procedures were performed: large bowel segmental resection with further anastomosis - in 38 cases, large bowel segmental resection with colostomy - in 38 cases, large bowel partial resection with colostomy - in 54 cases, right hemicolectomy with primary anastomosis - in 43 cases, left hemicolectomy with primary anastomosis - in 58 cases, manual intussusception reduction - in 65 cases, side anastomosis - in 31 cases. In 69 cases of bowel obstruction primary anastomosis was performed using the metal ring frame. Conclusion. To reduce the rate of complications, the need for the surgery should be diagnosed as soon as possible, coagulopathies should be compensated, and surgery tactics should be defined, including the primary anastomosis formation.