Acute intestinal obstruction. Diagnostics. Surgical treatment
M.M. MINNULLIN1, D.M. KRASILNIKOV2, А.P. TOLSTIKOV1
1Republican Clinical Hospital of the Ministry of Health of the Tatarstan Republic, 138 Orenburgskiy Trakt, Kazan, Russian Federation, 420064
2Kazan State Medical University, 49 Butlerov St., Kazan, Russian Federation, 420012
Minnullin M.М. — Cand. Med. Sc., First Deputy Chief Doctor, tel. (843) 231-20-60, e-mail: Marsel.Mansurovich@tatar.ru
Krasilnikov D.М. — D. Med. Sc., Professor, Head of the Surgery Department №1, tel. (843) 231-20-57, e-mail: dmkras131@gmail.com
Tolstikov A.Р. — Cand. Med. Sc., surgeon, tel. (843) 231-21-66, e-mail: tolstikovalexei@rambler.ru
The results of treatment of 546 patients with an acute intestinal obstruction are presented.. The diagnostic algorithm, as well as techniques for choosing the optimal surgical treatment of this pathology, are described. The modern principles of diagnostics and surgical treatment of an acute intestinal obstruction of a tumor genesis, adhesive and strangulated bowel obstruction are formulated. The endoscopic catheter contrast enterography is essential for the diagnosing of acute adhesive small bowel obstruction, and emergency colonoscopy is essential for the diagnosing of acute large bowel obstruction. The main criteria for choosing the volume and type of operation are the widespread peritonitis, and the stage of blastomatous process. Extraperitonization of the intestinal anastomosis reduces the frequency of sutures defects.
Key words: acute intestinal obstruction, adhesions, intestine tumors, diagnostics, surgical treatment.
REFERENCES
- Petrov V.P., Eryukhin I.A. Kishechnaya neprokhodimost’ [Intestinal obstruction]. Moscow: Meditsina, 1989. 288 p.
- Kriger A.C., Adreytsev I.L., Gorskiy V.A. Diagnosis and treatment of acute adhesive intestinal obstruction. Khirurgiya, 2001, no. 7, pp. 21-29 (in Russ.).
- Bailey I.S. Laparoscopic management of acute small bowel obstruction. Br. J.Surg, 2008, vol. 1, pp. 84-87.
- Kalff J.C. Surgical manipulation of the gut elicits an intestinal muscularis inflammatory response resulting in postsurgical ileus. Ann. Surg, 2007, vol. 1, pp. 228-232.
- Wilson M.S. Natural histiry of adhesional small bowel obstruction: counting the cost. Br. J. Surg, 2008, vol. 9, pp. 85-94.
- Chernov V.N., Khimichev V.G. A differentiated approach to the choice of tactics of treatment of patients with acute obstruction of the small intestine, depending on the stage of clinical course of the disease. Vestnik khirurgii, 1997, vol. 5, pp. 22-26 (in Russ.).
- Buyanov V.M., Maskin S.S. The current state of the diagnosis, surgical treatment methods of bowel obstruction. Annaly khirurgii, 1999, no. 2, pp. 23-31 (in Russ.).
- Briskin B.S., Smakov G.M., Borodin A.S. Obstructive obstruction in cancer of the colon. Khirurgiya, 1999, no. 5, pp. 37-40 (in Russ.).
- Scott-Coomb D.M. The human intraperitoneal fibrinolytic response to elective surgery. Dr. J. Surg, 2005, vol. 82, pp. 414-417.
- Senlin P. Small Intestine obstruction. Physiopathology, etiology, diagnosis, treatment. Rev. Prat, 2005, vol. 17, pp. 1927-1932.
- Minnullin M.M., Krasil’nikov D.M., Nikolaev Ya.Yu. Diagnosis and surgical treatment of patients with acute intestinal obstruction. Prakticheskaya meditsina, 2014, no. 2 (78), pp. 46-51 (in Russ.).
- Dederer Yu.M. Intestinal intubation through a gastrostomy to eliminate postoperative paralytic ileus. Klinicheskaya khirurgiya, 1962, no. 7, pp. 41-45 (in Russ.).