Bowel obstruction surgery: Difference between revisions
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==Surgery== | |||
===In Adults=== | |||
In adults, frequently the surgical intervention and the treatment of the causative lesion are required. In malignant large bowel obstruction, endoscopically placed self-expanding metal [[stents]] may be used to temporarily relieve the obstruction as a bridge to surgery, or as palliation. | |||
====Small Bowel obstruction==== | |||
In the management of small bowel obstructions it is often said that "[n]ever let the sun rise or set on small-bowel obstruction"<ref>{{cite journal |author=Maglinte DD, Kelvin FM, Rowe MG, Bender GN, Rouch DM |title=Small-bowel obstruction: optimizing radiologic investigation and nonsurgical management |journal=Radiology |volume=218 |issue=1 |pages=39-46 |year=2001 |pmid=11152777 |doi=}}[radiology.rsnajnls.org/cgi/reprint/218/1/39.pdf Free Full Text]. Accessed on: July 19, 2007.</ref> because they are sometimes fatal if treatment is delayed. | |||
Treatment for a small bowel obstruction is both non-surgical (conservative) and surgical. | |||
Conservative treatment involves insertion of a [[Nasogastric intubation|nasogastric tube]], correction of dehydration and [[electrolyte]] abnormalities. [[Opioid]] pain relievers may be used for patients with severe pain. [[Antiemetic]]s may be administered if the patient is vomiting. Adhesive obstructions often settle without surgery. If obstruction is complete a surgery is required. | |||
Small bowel obstruction caused by [[Crohn's disease]], peritoneal [[carcinomatosis]], sclerosing [[peritonitis]], [[Radiation enteropathy|radiation enteritis]] and postpartum bowel obstruction are typically treated conservatively, i.e. without surgery. Conversely, a small bowel obstruction in a "virgin abdomen" (an abdomen that has not seen an operation) is almost never treated conservatively. | |||
===Bowel obstruction in Children=== | |||
Fetal and neonatal bowel obstructions are often caused by an [[intestinal atresia]] where there is a narrowing or absence of a part of the intestine. These atresias are often discovered before birth via a [[sonogram]] and treated with using [[laparotomy]] after birth. If the area affected is small then the surgeon may be able to remove the damaged portion and join the intestine back together. In instantances where the narrowing is longer, or the area is damaged and cannot be used for a period of time, a temporary [[stoma (medicine)|stoma]] may be placed. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Needs | [[Category:Needs overview]] | ||
[[Category:General surgery]] | [[Category:General surgery]] | ||
[[Category:Medical emergencies]] | [[Category:Medical emergencies]] | ||
Revision as of 17:49, 4 February 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Surgery
In Adults
In adults, frequently the surgical intervention and the treatment of the causative lesion are required. In malignant large bowel obstruction, endoscopically placed self-expanding metal stents may be used to temporarily relieve the obstruction as a bridge to surgery, or as palliation.
Small Bowel obstruction
In the management of small bowel obstructions it is often said that "[n]ever let the sun rise or set on small-bowel obstruction"[1] because they are sometimes fatal if treatment is delayed.
Treatment for a small bowel obstruction is both non-surgical (conservative) and surgical.
Conservative treatment involves insertion of a nasogastric tube, correction of dehydration and electrolyte abnormalities. Opioid pain relievers may be used for patients with severe pain. Antiemetics may be administered if the patient is vomiting. Adhesive obstructions often settle without surgery. If obstruction is complete a surgery is required.
Small bowel obstruction caused by Crohn's disease, peritoneal carcinomatosis, sclerosing peritonitis, radiation enteritis and postpartum bowel obstruction are typically treated conservatively, i.e. without surgery. Conversely, a small bowel obstruction in a "virgin abdomen" (an abdomen that has not seen an operation) is almost never treated conservatively.
Bowel obstruction in Children
Fetal and neonatal bowel obstructions are often caused by an intestinal atresia where there is a narrowing or absence of a part of the intestine. These atresias are often discovered before birth via a sonogram and treated with using laparotomy after birth. If the area affected is small then the surgeon may be able to remove the damaged portion and join the intestine back together. In instantances where the narrowing is longer, or the area is damaged and cannot be used for a period of time, a temporary stoma may be placed.