| 1 | Acute mechanical bowel obstruction: Clinical presentation, etiology, management and outcome显示文摘AIM: To identify and analyze the clinical presentation, management and outcome of patients with acute mechanical bowel obstruction along with the etiology of obstruction and the incidence and causes of bowel ischemia, necrosis, and perforation. METHODS: This is a prospective observational study of all adult patients admitted with acute mechanical bowel obstruction between 2001 and 2002. RESULTS: Of the 150 consecutive patients included in the study, 114 (76%) presented with small bowel and 36 (24%) with large bowel obstruction. Absence of passage of flatus (90%) and/or feces (80.6%) and abdominal distension (65.3%) were the most common symptoms and physical finding, respectively. Adhesions (64.8%), incarcerated hernias (14.8%), and large bowel cancer (13.4%) were the most frequent causes of obstruction. Eighty-eight patients (58.7%) were treated conservatively and 62 (41.3%) were operated (29 on the first day). Bowel ischemia was found in 21 cases (14%), necrosis in 14 (9.3%), and perforation in 8 (5.3%). Hernias, large bowel cancer, and adhesions were the most frequent causes of bowel ischemia (57.2%, 19.1%, 14.3%), necrosis (42.8%, 21.4%, 21.4%), and perforation (50%, 25%, 25%). A significantly higher risk of strangulation was noticed in incarcerated hernias than all the other obstruction causes. CONCLUSION: Absence of passage of flatus and/or feces and abdominal distension are the most common symptoms and physical finding of patients with acute mechanical bowel obstruction, respectively. Adhesions, hernias, and large bowel cancer are the most commoncauses of obstruction, as well as of bowel ischemia, necrosis, and perforation. Although an important proportion of these patients can be nonoperatively treated, a substantial portion requires immediate operation. Great caution should be taken for the treatment of these patients since the incidence of bowel ischemia, necrosis, and perforation is significantly high. | Haridimos Markogiannakis Evangelos Messaris Dimitrios Dardamanis Nikolaos Pararas Dimitrios Tzertzemelis Panagiotis Giannopoulos Andreas Larentzakis Emmanuel Lagoudianakis Andreas Manouras Ioannis Bramis | 2007 | World Journal of Gastroenterology2007，13，3： | 7 |
| 3 | Lipoma induced jejunojejunal intussusception显示文摘Intussusception in adults is rare. The clinical picture of intussusception in adults is subtle and the diagnosis is,therefore,elusive. The presence of a structural abnor- mality in the great majority of the adult cases mandates high clinical suspicion. Gastrointestinal lipomas are rare benign tumors and intussusception due to a gastrointes- tinal lipoma constitutes an infrequent clinical entity. The present report describes a case of jejunojejunal intus- susception in an adult with a history of severe episodes of hematochezia and colicky upper abdominal pain. The diagnosis was suspected preoperatively but computed tomography scan could not rule out malignancy. Explor- atory laparotomy revealed jejunojejunal intussusception secondary to a lipoma which was successfully treated with segmental intestinal resection. | Andreas Manouras Emmanuel E Lagoudianakis Dimitrios Dardamanis Dimitrios K Tsekouras Haridimos Markogiannakis Michael Genetzakis Nikolaos Pararas Artemisia Papadima Christos Triantafillou Vagelogiannis Katergiannakis | 2007 | World Journal of Gastroenterology2007，13，26： | 4 |
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