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Larichev S.E.

Moscow City Clinical Hospital No. 17;
Pirogov Russian National Research Medical University

Shapovolyants S.G.

Pirogov Russian National Research Medical University

Zavyalov B.G.

Moscow City Clinical Hospital No. 17;
Pirogov Russian National Research Medical University

Shabrin A.V.

City Clinical Hospital No. 17;
Pirogov Russian National Research Medical University

Omelyanovich D.A.

City Clinical Hospital No. 17;
Pirogov Russian National Research Medical University

Zheleshchikov A.L.

City Clinical Hospital No. 17;
Pirogov Russian National Research Medical University

New approaches in conservative treatment of acute adhesive small bowel obstruction

Authors:

Larichev S.E., Shapovolyants S.G., Zavyalov B.G., Shabrin A.V., Omelyanovich D.A., Zheleshchikov A.L.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2021;(6): 45‑53

DOI: 10.17116/hirurgia202106145

Read: 8178 times

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Table of contents

NEW APPROACHES IN CONSERVATIVE TREATMENT OF ACUTE ADHESIVE SMALL BOWEL OBSTRUCTION
NEW APPROACHES IN CONSERVATIVE TREATMENT OF ACUTE ADHESIVE SMALL BOWEL OBSTRUCTION

To cite this article:

Larichev SE, Shapovolyants SG, Zavyalov BG, Shabrin AV, Omelyanovich DA, Zheleshchikov AL. New approaches in conservative treatment of acute adhesive small bowel obstruction. Pirogov Russian Journal of Surgery. 2021;(6):45‑53. (In Russ.)
https://doi.org/10.17116/hirurgia202106145

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

OBJECTIVE

To improve the outcomes of therapy of acute adhesive small bowel obstruction via development of a comprehensive management including CT, deep endoscopy-assisted nasointestinal drainage of small bowel with injection of a water-soluble contrast.

MATERIAL AND METHODS

There were 128 patients with acute adhesive small bowel obstruction for the period from 2015 to 2018. The study included 2 groups of patients depending on therapeutic approach and duration of treatment. In the first group, conventional approach for acute adhesive small bowel obstruction was applied. Upon admission, all patients with confirmed acute adhesive small bowel obstruction underwent gastric intubation for decompression of the upper gastrointestinal tract. Barium sulfate injection followed by X-ray examination was performed to assess an effectiveness of therapy. In the second group, computed tomography was performed in addition to X-ray examination and ultrasound. Moreover, conservative treatment included deep endoscopy-assisted nasointestinal drainage and subsequent administration of a water-soluble contrast in addition to traditional approaches.

RESULTS

Therapy was effective in 99 (71.2%) patients; 39 (28.8%) ones required surgery. Deep endoscopy-assisted nasointestinal drainage with injection of a water-soluble contrast was effective in 45 (78.9%) patients. Overall mortality in traditional approach was 1.4%, postoperative mortality — 3.7%. There were no lethal outcomes in case of a new approach.

CONCLUSION

Deep endoscopy-assisted nasointestinal drainage with injection of a water-soluble contrast is the most effective therapeutic method for acute adhesive small bowel obstruction (78.9%). These findings can significantly improve treatment outcomes in these patients.

Keywords:

acute adhesive small bowel obstruction
endoscopic nasointestinal drainage
water-soluble contrast agent
enterography
computed tomography

Authors:

Larichev S.E.

Moscow City Clinical Hospital No. 17;
Pirogov Russian National Research Medical University

Shapovolyants S.G.

Pirogov Russian National Research Medical University

Zavyalov B.G.

Moscow City Clinical Hospital No. 17;
Pirogov Russian National Research Medical University

Shabrin A.V.

City Clinical Hospital No. 17;
Pirogov Russian National Research Medical University

Omelyanovich D.A.

City Clinical Hospital No. 17;
Pirogov Russian National Research Medical University

Zheleshchikov A.L.

City Clinical Hospital No. 17;
Pirogov Russian National Research Medical University

Received:

04.06.2020

Accepted:

10.07.2020

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