Lithopedion is a rare clinical situation characterised by the calcification of a foetus that has died during an ectopic pregnancy, usually in the abdominal cavity. It occurs in 1.5 to 2% of ectopic pregnancies. It can...Lithopedion is a rare clinical situation characterised by the calcification of a foetus that has died during an ectopic pregnancy, usually in the abdominal cavity. It occurs in 1.5 to 2% of ectopic pregnancies. It can be asymptomatic for several years. However, various complications can occur that lead to diagnosis. The authors report a case of lithopedion complicated by acute intestinal obstruction in a 24-year-old woman in her first pregnancy. This complication occurred after 12 months of amenorrhoea. A mass containing a calcified foetus was removed by laparotomy.展开更多
BACKGROUND Colon cancer is one of the most common malignancies of the digestive tract,often complicated by intestinal obstruction,which can significantly impact patient outcomes.While traditional laparotomy is the sta...BACKGROUND Colon cancer is one of the most common malignancies of the digestive tract,often complicated by intestinal obstruction,which can significantly impact patient outcomes.While traditional laparotomy is the standard treatment,it is associated with large wounds,slower recovery,and higher complication rates.Laparoscopic surgery,a minimally invasive approach,may offer better outcomes for these patients.AIM To evaluate the clinical effects and prognosis of laparoscopic surgery in patients with colon cancer complicated by intestinal obstruction compared to traditional laparotomy.METHODS A retrospective analysis was conducted on 100 patients diagnosed with colon cancer and intestinal obstruction who underwent surgical treatment between January 2020 and December 2022.Patients were divided into two groups:The control group(CG),treated with traditional laparotomy,and the observation group(OG),treated with laparoscopic surgery.Clinical effects,surgical indicators,postoperative pain,inflammatory response,complication rates,quality of life,and prognosis were assessed and compared between the two groups.RESULTS The OG showed superior clinical outcomes compared to the CG(P<0.05).Patients in the OG had shorter operation times,reduced intraoperative blood loss,faster recovery of intestinal function,earlier mobilization,and shorter hospital stays(P<0.05).Postoperative pain(numerical rating scale scores)and inflam-matory markers[tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)]were lower in the OG(P<0.05).The incidence of complic-ations was significantly reduced in the OG(6.00%vs 22.00%,P<0.05).Quality of life scores,including physical function,psychological state,social communication,and self-care ability,were significantly higher in the OG(P<0.05).There were no significant differences between groups in abdominal drainage volume,1-year tumor recurrence or metastasis rates,or 1-and 3-year survival rates(P>0.05).CONCLUSION The OG showed superior clinical outcomes compared to the CG(P<0.05).Patients in the OG had shorter operation times,reduced intraoperative blood loss,faster recovery of intestinal function,earlier mobilization,and shorter hospital stays(P<0.05).Postoperative pain(NRS scores)and inflammatory markers(TNF-α,IL-6,CRP)were lower in the OG(P<0.05).The incidence of complications was significantly reduced in the OG(6.00%vs 22.00%,P<0.05).Quality of life scores,including physical function,psychological state,social communication,and self-care ability,were significantly higher in the OG(P<0.05).There were no significant differences between groups in abdominal drainage volume,1-year tumor recurrence or metastasis rates,or 1-and 3-year survival rates(P>0.05).展开更多
BACKGROUND Intestinal obstruction(IO)in pregnancy,though rare(1:1500-1:66000),carries high maternal(6%-10%)and fetal mortality(26%).Adhesions from prior surgery are the leading cause.Diagnosis is often delayed due to ...BACKGROUND Intestinal obstruction(IO)in pregnancy,though rare(1:1500-1:66000),carries high maternal(6%-10%)and fetal mortality(26%).Adhesions from prior surgery are the leading cause.Diagnosis is often delayed due to symptom overlap with nor-mal pregnancy,increasing risks of perforation and sepsis.CASE SUMMARY A 25-year-old gravida 2 para 1 woman at 28 weeks of gestation presented with 1-week constipation,feculent vomiting,and abdominal distension.She had a history of exploratory laparotomy in 2015 for blunt abdominal trauma.The diagnosis of IO in pregnancy was confirmed via abdominopelvic ultrasound and clinical findings.Interventions included conservative measures(nasogastric tube decompression,enemas)followed by emergency laparotomy with bowel resec-tion/anastomosis.Despite surgical management,the patient succumbed to septic shock.CONCLUSION High clinical suspicion,expedited cross-sectional imaging(computed tomogra-phy/Magnetic resonance imaging),and emergent surgery are critical to reduce mortality.展开更多
OBJECTIVE:To explore the treatment efficacy of integrated Chinese medicine(Chaihu Shugan San,柴胡疏肝散,CSS)and western therapy in the treatment of adhesive intestinal obstruction(AIO),to provide new ideas for the man...OBJECTIVE:To explore the treatment efficacy of integrated Chinese medicine(Chaihu Shugan San,柴胡疏肝散,CSS)and western therapy in the treatment of adhesive intestinal obstruction(AIO),to provide new ideas for the management of the disease.METHODS:In our single-blind randomized controlled study,120 patients with AIO who were hospitalized in The Affiliated Hospital of China West Normal University Nan Chong Gaoping District People's Hospital from January 2021 to June 2022 and met the inclusion criteria were categorized into the treatment group and the control group.Patients from the control group were administered basic Western Medicine therapy,whereas patients from the treatment group were administered basic Western Medicine therapy plus CSS by gastric tube injection.Subsequently,the time to first anal exhaustion and defecation,time to relief of abdominal distension and pain,days of hospitalization,Traditional Chinese Medicine(TCM)symptom scores,interleukin-6(IL-6),C-reactive protein(CRP)and procalcitonin(PCT)levels in the 2 groups were recorded and compared.RESULTS:The comparison of clinical efficacy of the treatment group were better than the control group.The TCM symptom score was considerably lower in the treatment group;the inflammation indicators CRP,IL-6,and PCT also decreased statistically when comparing the control group.Furthermore,there were significantly reduced in the time to first exhaustion,time to first defecation,time to relief of abdominal pain and distension,and days of hospitalization in the treatment group versus the control group.CONCLUSION:CSS could suppress the inflammatory reaction,reduce days of hospitalization,relieve clinical symptoms in AIO patients with reliable efficacy and high safety and is worthy of clinical application.展开更多
Objective: to analyze the effect of different operation time on the treatment of acute intestinal obstruction. Methods: 60 patients with acute intestinal obstruction admitted to our hospital were selected as research ...Objective: to analyze the effect of different operation time on the treatment of acute intestinal obstruction. Methods: 60 patients with acute intestinal obstruction admitted to our hospital were selected as research objects (the time range was from April 2019 to April 2020), and then they were equally included into the control group and the observation group according to the order of admission time. Conservative treatment and intervention were carried out in both groups, and appropriate therapeutic methods were selected according to the specific etiology, symptoms and signs of the patients. The operation time of the control group and the observation group were 48 hours after onset and 48 hours after onset, respectively. The clinical indexes and complications after treatment were compared between the two groups. Results: after treatment, compared with the control group, the gastrointestinal function recovery time, ambulation time and hospitalization time of the observation group were shorter, P < 0.05;The total incidence and mortality rate of postoperative complications were lower (P < 0.05). Conclusion: surgical treatment for acute intestinal obstruction patients within 48 hours of onset is effective, which can significantly speed up the prognosis and rehabilitation, reduce the incidence of postoperative complications and mortality, and is worthy of promotion and application.展开更多
BACKGROUND Recently,intestinal stenting combined with laparoscopic surgery has received increasing attention as a treatment option for acute intestinal obstruction.However,its safety and efficacy have not yet been est...BACKGROUND Recently,intestinal stenting combined with laparoscopic surgery has received increasing attention as a treatment option for acute intestinal obstruction.However,its safety and efficacy have not yet been established.AIM To assess the efficacy and safety of combining intestinal stenting with laparoscopic surgery for the management of acute intestinal obstruction.METHODS Clinical data from 74 patients with colorectal cancer and acute intestinal obstruction,who were admitted to the emergency department of the authors’hospital between October 2023 and November 2024,were collected and analyzed.Patients were divided into two groups based on the surgical intervention:A control group(emergency open surgery,n=37)and a study group(intestinal stent implantation combined with laparoscopic surgery,n=37).Observation indicators included stent placement rate,obstruction relief rate,and stent-related complications.RESULTS Intestinal stent placement was 100%successful in the study group,all of whom experienced relief from obstruction while exhibiting a significantly lower rate of ostomy creation and a higher rate of primary anastomosis than in the control group,as well as less intraoperative blood loss,shorter time to flatus,and shorter hospital stay.The complication rate was 5.41%(2/37;bleeding and re-obstruction),with no statistically significant difference between the two groups in terms of operative duration or perioperative mortality.The overall complication rates were 5.41%(2/37)and 21.62%(8/37)in the intervention and control groups,respectively.Tumor recurrence and overall survival rates were 2.70%and 97.30%in the study group and 13.51%and 91.89%in the control group,respectively.CONCLUSION Intestinal stenting relieved acute obstructions,reduced the number of emergency surgeries,and supported laparoscopic procedures while improving primary anastomosis rates,minimizing ostomy occurrence,surgical trauma,and complications,and accelerating recovery.展开更多
BACKGROUND Endoscopic submucosal dissection(ESD)is considered one of the effective and minimally invasive methods for managing lateral spreading tumors of the intestine.However,with the widespread adoption of this tec...BACKGROUND Endoscopic submucosal dissection(ESD)is considered one of the effective and minimally invasive methods for managing lateral spreading tumors of the intestine.However,with the widespread adoption of this technique,the incidence of complications is expected to increase.The most common complications of ESD are hemorrhage and perforation.Rare cases of obstruction after colorectal ESD have been reported,which are often easily misdiagnosed.Therefore,clinicians should maintain heightened awareness of this complication.CASE SUMMARY We report the case of a 50-year-old male who developed bowel obstruction following ESD.On the second day after the procedure,the patient presented with fever and a mild left lower abdominal pain.Physical examination revealed tenderness and rebound tenderness in the left lower quadrant.Plain abdominal radiographs demonstrated air-fluid levels and dilatation of the proximal bowel.The patient continued to fast and was treated with intravenous antibiotics.On the third postoperative day,he developed abdominal distension in the lower abdomen and vomited approximately 200 mL of greenish-yellow fluid,with no bowel movement for two days after the procedure.A diagnosis of obstruction after ESD was made.Continuous gastrointestinal decompression was initiated on the fourth day,resulting in symptomatic improvement.Follow-up abdominal radiographs showed marked improvement in the obstruction compared with prior imaging.The patient resumed oral intake and was discharged uneventfully on the eighth postoperative day.CONCLUSION Acute intestinal obstruction after ESD is a rare complication.Delayed diagnosis or misdiagnosis may be life-threatening.Clinicians should be vigilant for this condition following ESD.展开更多
BACKGROUND Ileum adenocarcinoma(IA),a type of small bowel adenocarcinoma,is a rather uncommon factor associated with obstruction in small bowel.Owing to its location and indefinite clinical symptoms,the diagnosis of I...BACKGROUND Ileum adenocarcinoma(IA),a type of small bowel adenocarcinoma,is a rather uncommon factor associated with obstruction in small bowel.Owing to its location and indefinite clinical symptoms,the diagnosis of IA is difficult,and survival is usually poor.With respect to the rarity of this disease,very few studies have reported such cases to provide a reference for treatment.CASE SUMMARY In this manuscript,a case of a 48-year-old man presented with chronic right lower abdominal pain and distention,queasiness and emesis.A computed tomography scan revealed intestinal wall thickening and an intestinal obstruction in the terminal ileum.He was diagnosed with inflammatory bowel disease.However,his symptoms were not relieved after conservative treatment.The patient sub-sequently underwent exploratory laparotomy,and a tumour in the ileum measuring approximately 2.0 cm×2.0 cm that was located 20 cm from the ileocolic valve was discovered incidentally and was operatively resected along with the enlarged lymph nodes.Pathological examination revealed a stage IIA(T3N0M0)ulcerative IA.Along with imaging examinations,a diagnosis of primary IA with no lymph or distant metastases was considered.The patient was discharged and recovered well as of the writing of this manuscript.CONCLUSION IA should be considered as a differential diagnosis in cases of intestinal obstruction,and the recommended method for local disease treatment is surgery.展开更多
Background:Intestinal obstruction is a prevalent complication in patients with colorectal cancer following surgery,with a significant impact on health outcomes.Dachengqi decoction(DCQD)is a traditional Chinese medicin...Background:Intestinal obstruction is a prevalent complication in patients with colorectal cancer following surgery,with a significant impact on health outcomes.Dachengqi decoction(DCQD)is a traditional Chinese medicine(TCM)that is employed in clinical settings for the treatment of intestinal obstruction.However,the pharmacological mechanisms and active components of this medicinal preparation remain to be fully elucidated.The objective of this study was to examine the possible mechanisms and active constituents of DCQD in addressing intestinal obstruction subsequent to colorectal cancer surgery.Methods:A comprehensive search was conducted on the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform and the Traditional Chinese Medicine Integrated Database for the active chemical constituents of DCQD.In addition,the PubChem,Swiss Target Prediction and Uniprot databases were utilised to predict the drug targets.The possible target genes associated with intestinal obstruction were obtained from the GeneCards,Online Mendelian Inheritance in Man,PharmGKB,and Therapeutic Target Database databases,and were analysed using the Database for Annotation,Visualisation and Integrated Discovery platform for Gene Ontology(GO)functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis.Cytoscape was utilised to visualise key components,targets,and pathways,and molecular docking technology was employed to verify the binding of core targets and key components.Results:A total of 41 active chemical components and 141 intersecting targets were screened,and it was determined that the intersecting targets of TCM and disease were significantly enriched in 44 GO entries and 93 KEGG pathways.Subsequent screening identified 3 key components(isosinensetin,tetramethoxyluteolin,and 5,7,4’-trimethylapigenin)and 9 core targets(TP53,STAT3,ESR1,SRC,EGFR,AKT1,CTNNB1,BCL2,and PIK3CA).The molecular docking results demonstrated that all 3 key components exhibited strong binding to the core targets.Conclusions:The present study identified the pharmacological basis by which DCQD exerts beneficial effects against intestinal obstruction and provided insights into its mechanism of action,providing scientific evidence for precise clinical utilisation and areas for new drug development.展开更多
BACKGROUND The gut-vascular barrier(GVB)is critical for maintaining intestinal homeostasis,but its involvement in intestinal obstruction(IO)remains unclear.AIM To investigate GVB disruption in patients with IO and its...BACKGROUND The gut-vascular barrier(GVB)is critical for maintaining intestinal homeostasis,but its involvement in intestinal obstruction(IO)remains unclear.AIM To investigate GVB disruption in patients with IO and its association with perioperative infection,organ injury,and clinical prognosis.METHODS Intestinal tissues from surgical patients with IO(IO group)and without obstruction(control group)were analyzed for PV1,a biomarker of GVB disruption.In the IO group,PV1 expression correlated with clinical data.Patients were further stratified into PV1-high and PV1-low subgroups,and clinical parameters were compared.RESULTS PV1 expression was significantly elevated in the IO group.In the IO group,PV1 levels were positively correlated with perioperative infection markers,liver and kidney injury indices,and adverse prognostic indicators,including prolonged hospitalization,antibiotic use,fever duration,and postoperative complications.Several of these outcomes were significantly worse in the PV1-high subgroup than in the PV1-low subgroup,although severe postoperative complications and mortality did not differ.CONCLUSION Our findings demonstrate that IO induces GVB damage,and the extent of impairment is closely associated with infection,organ injury,and adverse clinical outcomes in surgical patients,suggesting a pathogenic role for GVB disruption in IO.展开更多
For renal transplant recipients, intestinal obstruction caused by incisional hernia is a rarely encountered event. Until now, there is no specific literature concerning the adjustment of immunosuppressants under such ...For renal transplant recipients, intestinal obstruction caused by incisional hernia is a rarely encountered event. Until now, there is no specific literature concerning the adjustment of immunosuppressants under such clinical condition. We present such a case who received a successful long-term single intravenous prograf administration to transitionally maintain the immunosuppression.展开更多
Objective:To study the effect of nutritional support + intravenous chemotherapy on anti-tumor immunity and cancer cell proliferation in patients with colon cancer complicated by incomplete intestinal obstruction.Metho...Objective:To study the effect of nutritional support + intravenous chemotherapy on anti-tumor immunity and cancer cell proliferation in patients with colon cancer complicated by incomplete intestinal obstruction.Methods: Patients with colon cancer complicated by incomplete intestinal obstruction who were treated in Midi Branch, Pangang Group General Hospital between March 2015 and October 2017 were selected and randomly divided into the nutrition group who accepted nutritional support + FOLFOX4 intravenous chemotherapy and the control group who accepted FOLFOX4 intravenous chemotherapy alone, and they underwent surgery after two cycles of chemotherapy. The contents of immune cells in peripheral blood and the contents of immune cytokines in serum were determined before chemotherapy and two cycles after chemotherapy;the expression levels of proliferation genes in colon cancer lesions were determined after surgical resection.Results:Compared with those of same group before chemotherapy, peripheral blood Treg, Th9, Th17 and Th22 contents as well as serum IL-4, IL-9, IL-10, TGF-β1, IL-17 and IL-22 contents of nutrition group were decreased significantly after chemotherapywhereas peripheral blood Treg, Th9, Th17 and Th22 contents as well as serum IL-4, IL-9, IL-10, TGF-β1, IL-17 and IL-22 contents of control group did not change significantly after chemotherapy, and compared with those after chemotherapy between groups, peripheral blood Treg, Th9, Th17 and Th22 contents as well as serum IL-4, IL-9, IL-10, TGF-β1, IL-17 and IL-22 contents of nutrition group were significantly lower than those of control group, and CyclinD1, Bcl-2, USP22, VEGF and N-cadherin mRNA expression were not different from those of control group.Conclusion:Nutritional support + intravenous chemotherapy can improve the anti-tumor immune response without affecting the proliferation of cancer cells in the lesion of patients with colon cancer complicated by incomplete intestinal obstruction.展开更多
To study and analyze the case data of an elderly patient with cervical cancer complicated with intestinal obstruction and incision dehiscence after operation, to explore the risk factors of postoperative complications...To study and analyze the case data of an elderly patient with cervical cancer complicated with intestinal obstruction and incision dehiscence after operation, to explore the risk factors of postoperative complications of elderly patients with cervical cancer, and to explore the key points of postoperative care and experience of such patients combined with clinical practice.展开更多
Objective: to analyze the role of psychological nursing mode in the preoperative bowel clearing management of patients with colorectal cancer and intestinal obstruction. Methods: a total of 100 patients with colorecta...Objective: to analyze the role of psychological nursing mode in the preoperative bowel clearing management of patients with colorectal cancer and intestinal obstruction. Methods: a total of 100 patients with colorectal cancer complicated with intestinal obstruction admitted to our hospital from March 2020 to February 2021 were included in the randomized group. The control group received routine preoperative intestinal irrigation management and had no difference with the seamless nursing model group. For nursing model, complications were compared between the two groups. Results: the incidence of postoperative infection and bleeding in the seamless nursing model group was lower than that in the control group. Conclusion: the smooth nursing mode and effect of patients with colorectal cancer and intestinal obstruction are accurate, can reduce complications, and is worthy of popularization and application.展开更多
This study summarizes the nursing experience of a patient with active Crohn’s disease in the acute stage,complicated by small bowel obstruction.Key aspects of nursing include psychological response guidance during th...This study summarizes the nursing experience of a patient with active Crohn’s disease in the acute stage,complicated by small bowel obstruction.Key aspects of nursing include psychological response guidance during the active phase of Crohn’s disease,support before and after various gastroenteroscopy procedures and related reports,and self-monitoring guidance for symptoms such as intestinal obstruction combined with endoscopic mucosal ulcers.Using the 5A nursing model,nursing staff assessed the patient’s needs,provided targeted nursing recommendations in stages,implemented health behavior strategies,and offered continuous nursing care,including positive support for sexual health beliefs.These interventions helped the patient overcome psychological challenges,such as resistance to indwelling gastric tubes,and adopt healthy behaviors.After six weeks of follow-up through phone and WeChat consultations,the patient demonstrated significant improvement,including a weight gain of 15 kg.Various test results indicated normalized nutritional and inflammatory indexes,and the Crohn’s Disease Activity Index decreased by≥70 points.In conclusion,establishing a nursing team and applying the 5A nursing model to formulate detailed nursing diagnoses and interventions can significantly improve outcomes for patients with active Crohn’s disease complicated by small intestinal obstruction.展开更多
Hepatic hemangiomas are the most common benign tumor of the liver.Most hepatic hemangiomas remain asymptomatic and require no treatment.Giant hepatic hemangiomas with established complications,diagnostic uncertainty a...Hepatic hemangiomas are the most common benign tumor of the liver.Most hepatic hemangiomas remain asymptomatic and require no treatment.Giant hepatic hemangiomas with established complications,diagnostic uncertainty and incapacitating symptoms,however,are generally considered an absolute indication for surgical resection.We present a case of a giant hemangioma with intestinal obstruction following transcatheter arterial embolization,by which the volume of the hemangioma was significantly reduced,and it was completely resected by a left hepatectomy.A 21-yearold Asian man visited our hospital for left upper quadrant pain.Examinations at the first visit revealed a left liver hemangioma occupying the abdominal cavity,with a maximum diameter of 31.5 cm.Embolization of the left hepatic artery was performed and confirmed a decrease in its size.However,the patient was readmitted to our hospital one month after embolization for intestinal obstruction.A left hepatectomy was completed through a herringbone incision,and safely removed a giant hemangioma of 26.5 cm × 19.5 cm × 12.0 cm in size and 3690 g in weight.Pre-operative arterial embolization is effective for reducing tumor size,but a close follow-up to decide the time for hepatectomy is important.展开更多
AIM:To investigate different methods of creating incomplete intestinal obstruction in a rat model and to compare their electrophysiologic,morphologic and histologic characteristics. METHODS:Rat ileum was partially obs...AIM:To investigate different methods of creating incomplete intestinal obstruction in a rat model and to compare their electrophysiologic,morphologic and histologic characteristics. METHODS:Rat ileum was partially obstructed by the respective application of:braided silk(penetrated the mesentery and surrounded intestine);half ligation (penetrated directly and ligated 1/2 cross-section of the intestine);wide pipe(6 mm in width,surrounded the intestine);narrow pipe(2 mm in width,surrounded the intestine).A control was also included(no obstruction). Various behavioral and electrophysiologic variables, as well as morphologic and immunohistochemical observations were recorded by blinded investigators at different time points(12,24,48,72 h),including daily general condition,ileal wet weight and circumference, macromorphous and micromorphous intestine,bowel movement capability in vivo and in vitro,slow wave and neural electrical activity,and the number of c-Kit positive interstitial cells of Cajal(ICC). RESULTS:Despite being of a similar general condition, these methods resulted in different levels of obstruction in each group compared with the control at different time points(12,24,48,72 h).However,these fields of the wide pipe rat showed significantly differences when compared with the other three obstructed groups at 12 to 72 h,including macroscopic and histological presentation,intestinal transit ratio and contractility,circumference and wet weight,amplitude and frequency of nerve electrical discharge and slow wave,and ICC numbers(all P<0.01). CONCLUSION:The wide pipe rat method is significantly more reliable and stable than the other methods of obstruction,demonstrating that use of the wide pipe method can be a useful model of incomplete intestinal obstruction.展开更多
AIM: To investigate the long-term follow-up of distal intestinal obstruction syndrome(DIOS) in Israeli cystic fibrosis(CF) patients.METHODS: This is a multi-center,comparative,retrospective study in which we reviewed ...AIM: To investigate the long-term follow-up of distal intestinal obstruction syndrome(DIOS) in Israeli cystic fibrosis(CF) patients.METHODS: This is a multi-center,comparative,retrospective study in which we reviewed the medical records of all CF patients from three major CF centers in Israel who were treated in the period from 1980 to 2012.Patients diagnosed with DIOS were defined as the study group.The patients were diagnosed with DIOS based on their clinical presentation and typical findings on either abdominal X-ray or computerized tomography scan.For the control group,CF patients with no DIOS were matched to the patients in the study group for age,sex,and cystic fibrosis transmembrane conductance regulator(CFTR) mutations.For both groups,the collected data included age,sex,CFTR genotype,weight,height,and body mass index.Clinical data included respiratory function tests in the last five years prior to the study,respiratory function test immediately before and after the DIOS event,number of hospitalizations,sputum culture results,and CFrelated conditions diagnosed according to the CF clinical practice guidelines.In the study group,data on the DIOS treatment and tendency for DIOS recurrence were also analyzed.RESULTS: The medical charts for a total of 350 CF patients were reviewed.Of the 350 CF patients,26(7.4%) were diagnosed with DIOS.The control group included 31 CF patients with no DIOS diagnosis.The mean follow-up period was 21.6 ± 8.2 years.The total of DIOS episodes in the follow-up period was 60.The distribution of DIOS episodes was as follows: 6/26(23.1%) study patients had one episode of DIOS intheir lifetime,7/26(26.9%) had two episodes,7/26(26.9%) had three episodes,and 6/26(23.1%) had four or more episodes.Compared to the control group,DIOS patients had a significantly higher incidence of meconium ileus in the past(65.4% vs 0%,respectively,P < 0.02),more Aspergillus spp.colonization(34.6% vs 3.2%,respectively,P < 0.02),and a higher number of hospitalizations due to respiratory exacerbations(8.6 vs 6.2 mean total hospitalizations per follow-up period,respectively,P < 0.02).No other significant differences were found between the control and study groups.The conservative treatment of DIOS,which mainly includes hydration and stool softeners,was successful in 82% of the episodes.The survival rate was similar for both groups.CONCLUSION: CF patients with DIOS suffer from recurrent hospitalizations and airway pathogen acquisition.Although recurrence of DIOS is common,conservative treatment is successful in most patients.展开更多
Abdominal cocoon syndrome is a rare cause of intestinal obstruction with unknown etiology. Diagnosis of this syndrome, which can be summarized as the small intestine being surrounded by a fibrous capsule not containin...Abdominal cocoon syndrome is a rare cause of intestinal obstruction with unknown etiology. Diagnosis of this syndrome, which can be summarized as the small intestine being surrounded by a fibrous capsule not containing the mesothelium, is difficult in the preoperative period. A 47-year-old male patient was referred to the emergency department with complaints of abdominal pain, nausea, and vomiting for two days. The abdominal computed tomography examination detected dilated small intestinal loops containing air-fluid levels clustered in the left upper quadrant of the abdomen and surrounded by a thick, saclike, contrast-enhanced membrane. During exploratory surgery, a capsular structure was identified in the upper left quadrant with a regular surface that was solid-fibrous in nature. Ab-dominal cocoon syndrome is a rarely seen condition, for which the preoperative diagnosis is difficult. The combination of physical examination and radiological signs, and the knowledge of "recurrent characteristics of the complaints" that can be learned by a careful history, may be helpful in diagnosis.展开更多
文摘Lithopedion is a rare clinical situation characterised by the calcification of a foetus that has died during an ectopic pregnancy, usually in the abdominal cavity. It occurs in 1.5 to 2% of ectopic pregnancies. It can be asymptomatic for several years. However, various complications can occur that lead to diagnosis. The authors report a case of lithopedion complicated by acute intestinal obstruction in a 24-year-old woman in her first pregnancy. This complication occurred after 12 months of amenorrhoea. A mass containing a calcified foetus was removed by laparotomy.
文摘BACKGROUND Colon cancer is one of the most common malignancies of the digestive tract,often complicated by intestinal obstruction,which can significantly impact patient outcomes.While traditional laparotomy is the standard treatment,it is associated with large wounds,slower recovery,and higher complication rates.Laparoscopic surgery,a minimally invasive approach,may offer better outcomes for these patients.AIM To evaluate the clinical effects and prognosis of laparoscopic surgery in patients with colon cancer complicated by intestinal obstruction compared to traditional laparotomy.METHODS A retrospective analysis was conducted on 100 patients diagnosed with colon cancer and intestinal obstruction who underwent surgical treatment between January 2020 and December 2022.Patients were divided into two groups:The control group(CG),treated with traditional laparotomy,and the observation group(OG),treated with laparoscopic surgery.Clinical effects,surgical indicators,postoperative pain,inflammatory response,complication rates,quality of life,and prognosis were assessed and compared between the two groups.RESULTS The OG showed superior clinical outcomes compared to the CG(P<0.05).Patients in the OG had shorter operation times,reduced intraoperative blood loss,faster recovery of intestinal function,earlier mobilization,and shorter hospital stays(P<0.05).Postoperative pain(numerical rating scale scores)and inflam-matory markers[tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)]were lower in the OG(P<0.05).The incidence of complic-ations was significantly reduced in the OG(6.00%vs 22.00%,P<0.05).Quality of life scores,including physical function,psychological state,social communication,and self-care ability,were significantly higher in the OG(P<0.05).There were no significant differences between groups in abdominal drainage volume,1-year tumor recurrence or metastasis rates,or 1-and 3-year survival rates(P>0.05).CONCLUSION The OG showed superior clinical outcomes compared to the CG(P<0.05).Patients in the OG had shorter operation times,reduced intraoperative blood loss,faster recovery of intestinal function,earlier mobilization,and shorter hospital stays(P<0.05).Postoperative pain(NRS scores)and inflammatory markers(TNF-α,IL-6,CRP)were lower in the OG(P<0.05).The incidence of complications was significantly reduced in the OG(6.00%vs 22.00%,P<0.05).Quality of life scores,including physical function,psychological state,social communication,and self-care ability,were significantly higher in the OG(P<0.05).There were no significant differences between groups in abdominal drainage volume,1-year tumor recurrence or metastasis rates,or 1-and 3-year survival rates(P>0.05).
文摘BACKGROUND Intestinal obstruction(IO)in pregnancy,though rare(1:1500-1:66000),carries high maternal(6%-10%)and fetal mortality(26%).Adhesions from prior surgery are the leading cause.Diagnosis is often delayed due to symptom overlap with nor-mal pregnancy,increasing risks of perforation and sepsis.CASE SUMMARY A 25-year-old gravida 2 para 1 woman at 28 weeks of gestation presented with 1-week constipation,feculent vomiting,and abdominal distension.She had a history of exploratory laparotomy in 2015 for blunt abdominal trauma.The diagnosis of IO in pregnancy was confirmed via abdominopelvic ultrasound and clinical findings.Interventions included conservative measures(nasogastric tube decompression,enemas)followed by emergency laparotomy with bowel resec-tion/anastomosis.Despite surgical management,the patient succumbed to septic shock.CONCLUSION High clinical suspicion,expedited cross-sectional imaging(computed tomogra-phy/Magnetic resonance imaging),and emergent surgery are critical to reduce mortality.
基金Nanchong City Science and Technology Plan Project:the Application of Tongli Shugan Liqi Method in the Treatment of Adhesive Intestinal Obstruction and its Effect on Inflammatory Indicators Interleukin-6,C-reactive protein and Procalcitonin(21YFZJ0108)。
文摘OBJECTIVE:To explore the treatment efficacy of integrated Chinese medicine(Chaihu Shugan San,柴胡疏肝散,CSS)and western therapy in the treatment of adhesive intestinal obstruction(AIO),to provide new ideas for the management of the disease.METHODS:In our single-blind randomized controlled study,120 patients with AIO who were hospitalized in The Affiliated Hospital of China West Normal University Nan Chong Gaoping District People's Hospital from January 2021 to June 2022 and met the inclusion criteria were categorized into the treatment group and the control group.Patients from the control group were administered basic Western Medicine therapy,whereas patients from the treatment group were administered basic Western Medicine therapy plus CSS by gastric tube injection.Subsequently,the time to first anal exhaustion and defecation,time to relief of abdominal distension and pain,days of hospitalization,Traditional Chinese Medicine(TCM)symptom scores,interleukin-6(IL-6),C-reactive protein(CRP)and procalcitonin(PCT)levels in the 2 groups were recorded and compared.RESULTS:The comparison of clinical efficacy of the treatment group were better than the control group.The TCM symptom score was considerably lower in the treatment group;the inflammation indicators CRP,IL-6,and PCT also decreased statistically when comparing the control group.Furthermore,there were significantly reduced in the time to first exhaustion,time to first defecation,time to relief of abdominal pain and distension,and days of hospitalization in the treatment group versus the control group.CONCLUSION:CSS could suppress the inflammatory reaction,reduce days of hospitalization,relieve clinical symptoms in AIO patients with reliable efficacy and high safety and is worthy of clinical application.
文摘Objective: to analyze the effect of different operation time on the treatment of acute intestinal obstruction. Methods: 60 patients with acute intestinal obstruction admitted to our hospital were selected as research objects (the time range was from April 2019 to April 2020), and then they were equally included into the control group and the observation group according to the order of admission time. Conservative treatment and intervention were carried out in both groups, and appropriate therapeutic methods were selected according to the specific etiology, symptoms and signs of the patients. The operation time of the control group and the observation group were 48 hours after onset and 48 hours after onset, respectively. The clinical indexes and complications after treatment were compared between the two groups. Results: after treatment, compared with the control group, the gastrointestinal function recovery time, ambulation time and hospitalization time of the observation group were shorter, P < 0.05;The total incidence and mortality rate of postoperative complications were lower (P < 0.05). Conclusion: surgical treatment for acute intestinal obstruction patients within 48 hours of onset is effective, which can significantly speed up the prognosis and rehabilitation, reduce the incidence of postoperative complications and mortality, and is worthy of promotion and application.
文摘BACKGROUND Recently,intestinal stenting combined with laparoscopic surgery has received increasing attention as a treatment option for acute intestinal obstruction.However,its safety and efficacy have not yet been established.AIM To assess the efficacy and safety of combining intestinal stenting with laparoscopic surgery for the management of acute intestinal obstruction.METHODS Clinical data from 74 patients with colorectal cancer and acute intestinal obstruction,who were admitted to the emergency department of the authors’hospital between October 2023 and November 2024,were collected and analyzed.Patients were divided into two groups based on the surgical intervention:A control group(emergency open surgery,n=37)and a study group(intestinal stent implantation combined with laparoscopic surgery,n=37).Observation indicators included stent placement rate,obstruction relief rate,and stent-related complications.RESULTS Intestinal stent placement was 100%successful in the study group,all of whom experienced relief from obstruction while exhibiting a significantly lower rate of ostomy creation and a higher rate of primary anastomosis than in the control group,as well as less intraoperative blood loss,shorter time to flatus,and shorter hospital stay.The complication rate was 5.41%(2/37;bleeding and re-obstruction),with no statistically significant difference between the two groups in terms of operative duration or perioperative mortality.The overall complication rates were 5.41%(2/37)and 21.62%(8/37)in the intervention and control groups,respectively.Tumor recurrence and overall survival rates were 2.70%and 97.30%in the study group and 13.51%and 91.89%in the control group,respectively.CONCLUSION Intestinal stenting relieved acute obstructions,reduced the number of emergency surgeries,and supported laparoscopic procedures while improving primary anastomosis rates,minimizing ostomy occurrence,surgical trauma,and complications,and accelerating recovery.
文摘BACKGROUND Endoscopic submucosal dissection(ESD)is considered one of the effective and minimally invasive methods for managing lateral spreading tumors of the intestine.However,with the widespread adoption of this technique,the incidence of complications is expected to increase.The most common complications of ESD are hemorrhage and perforation.Rare cases of obstruction after colorectal ESD have been reported,which are often easily misdiagnosed.Therefore,clinicians should maintain heightened awareness of this complication.CASE SUMMARY We report the case of a 50-year-old male who developed bowel obstruction following ESD.On the second day after the procedure,the patient presented with fever and a mild left lower abdominal pain.Physical examination revealed tenderness and rebound tenderness in the left lower quadrant.Plain abdominal radiographs demonstrated air-fluid levels and dilatation of the proximal bowel.The patient continued to fast and was treated with intravenous antibiotics.On the third postoperative day,he developed abdominal distension in the lower abdomen and vomited approximately 200 mL of greenish-yellow fluid,with no bowel movement for two days after the procedure.A diagnosis of obstruction after ESD was made.Continuous gastrointestinal decompression was initiated on the fourth day,resulting in symptomatic improvement.Follow-up abdominal radiographs showed marked improvement in the obstruction compared with prior imaging.The patient resumed oral intake and was discharged uneventfully on the eighth postoperative day.CONCLUSION Acute intestinal obstruction after ESD is a rare complication.Delayed diagnosis or misdiagnosis may be life-threatening.Clinicians should be vigilant for this condition following ESD.
文摘BACKGROUND Ileum adenocarcinoma(IA),a type of small bowel adenocarcinoma,is a rather uncommon factor associated with obstruction in small bowel.Owing to its location and indefinite clinical symptoms,the diagnosis of IA is difficult,and survival is usually poor.With respect to the rarity of this disease,very few studies have reported such cases to provide a reference for treatment.CASE SUMMARY In this manuscript,a case of a 48-year-old man presented with chronic right lower abdominal pain and distention,queasiness and emesis.A computed tomography scan revealed intestinal wall thickening and an intestinal obstruction in the terminal ileum.He was diagnosed with inflammatory bowel disease.However,his symptoms were not relieved after conservative treatment.The patient sub-sequently underwent exploratory laparotomy,and a tumour in the ileum measuring approximately 2.0 cm×2.0 cm that was located 20 cm from the ileocolic valve was discovered incidentally and was operatively resected along with the enlarged lymph nodes.Pathological examination revealed a stage IIA(T3N0M0)ulcerative IA.Along with imaging examinations,a diagnosis of primary IA with no lymph or distant metastases was considered.The patient was discharged and recovered well as of the writing of this manuscript.CONCLUSION IA should be considered as a differential diagnosis in cases of intestinal obstruction,and the recommended method for local disease treatment is surgery.
基金funded by the Jining Key Research and Development Plan(No.2024YXNS267).
文摘Background:Intestinal obstruction is a prevalent complication in patients with colorectal cancer following surgery,with a significant impact on health outcomes.Dachengqi decoction(DCQD)is a traditional Chinese medicine(TCM)that is employed in clinical settings for the treatment of intestinal obstruction.However,the pharmacological mechanisms and active components of this medicinal preparation remain to be fully elucidated.The objective of this study was to examine the possible mechanisms and active constituents of DCQD in addressing intestinal obstruction subsequent to colorectal cancer surgery.Methods:A comprehensive search was conducted on the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform and the Traditional Chinese Medicine Integrated Database for the active chemical constituents of DCQD.In addition,the PubChem,Swiss Target Prediction and Uniprot databases were utilised to predict the drug targets.The possible target genes associated with intestinal obstruction were obtained from the GeneCards,Online Mendelian Inheritance in Man,PharmGKB,and Therapeutic Target Database databases,and were analysed using the Database for Annotation,Visualisation and Integrated Discovery platform for Gene Ontology(GO)functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis.Cytoscape was utilised to visualise key components,targets,and pathways,and molecular docking technology was employed to verify the binding of core targets and key components.Results:A total of 41 active chemical components and 141 intersecting targets were screened,and it was determined that the intersecting targets of TCM and disease were significantly enriched in 44 GO entries and 93 KEGG pathways.Subsequent screening identified 3 key components(isosinensetin,tetramethoxyluteolin,and 5,7,4’-trimethylapigenin)and 9 core targets(TP53,STAT3,ESR1,SRC,EGFR,AKT1,CTNNB1,BCL2,and PIK3CA).The molecular docking results demonstrated that all 3 key components exhibited strong binding to the core targets.Conclusions:The present study identified the pharmacological basis by which DCQD exerts beneficial effects against intestinal obstruction and provided insights into its mechanism of action,providing scientific evidence for precise clinical utilisation and areas for new drug development.
基金Supported by National Natural Science Foundation of China,No.82072204 and No.81701874Natural Science Foundation of Guangdong Province,China,No.2021A1515010990 and No.2025A1515012493.
文摘BACKGROUND The gut-vascular barrier(GVB)is critical for maintaining intestinal homeostasis,but its involvement in intestinal obstruction(IO)remains unclear.AIM To investigate GVB disruption in patients with IO and its association with perioperative infection,organ injury,and clinical prognosis.METHODS Intestinal tissues from surgical patients with IO(IO group)and without obstruction(control group)were analyzed for PV1,a biomarker of GVB disruption.In the IO group,PV1 expression correlated with clinical data.Patients were further stratified into PV1-high and PV1-low subgroups,and clinical parameters were compared.RESULTS PV1 expression was significantly elevated in the IO group.In the IO group,PV1 levels were positively correlated with perioperative infection markers,liver and kidney injury indices,and adverse prognostic indicators,including prolonged hospitalization,antibiotic use,fever duration,and postoperative complications.Several of these outcomes were significantly worse in the PV1-high subgroup than in the PV1-low subgroup,although severe postoperative complications and mortality did not differ.CONCLUSION Our findings demonstrate that IO induces GVB damage,and the extent of impairment is closely associated with infection,organ injury,and adverse clinical outcomes in surgical patients,suggesting a pathogenic role for GVB disruption in IO.
文摘For renal transplant recipients, intestinal obstruction caused by incisional hernia is a rarely encountered event. Until now, there is no specific literature concerning the adjustment of immunosuppressants under such clinical condition. We present such a case who received a successful long-term single intravenous prograf administration to transitionally maintain the immunosuppression.
文摘Objective:To study the effect of nutritional support + intravenous chemotherapy on anti-tumor immunity and cancer cell proliferation in patients with colon cancer complicated by incomplete intestinal obstruction.Methods: Patients with colon cancer complicated by incomplete intestinal obstruction who were treated in Midi Branch, Pangang Group General Hospital between March 2015 and October 2017 were selected and randomly divided into the nutrition group who accepted nutritional support + FOLFOX4 intravenous chemotherapy and the control group who accepted FOLFOX4 intravenous chemotherapy alone, and they underwent surgery after two cycles of chemotherapy. The contents of immune cells in peripheral blood and the contents of immune cytokines in serum were determined before chemotherapy and two cycles after chemotherapy;the expression levels of proliferation genes in colon cancer lesions were determined after surgical resection.Results:Compared with those of same group before chemotherapy, peripheral blood Treg, Th9, Th17 and Th22 contents as well as serum IL-4, IL-9, IL-10, TGF-β1, IL-17 and IL-22 contents of nutrition group were decreased significantly after chemotherapywhereas peripheral blood Treg, Th9, Th17 and Th22 contents as well as serum IL-4, IL-9, IL-10, TGF-β1, IL-17 and IL-22 contents of control group did not change significantly after chemotherapy, and compared with those after chemotherapy between groups, peripheral blood Treg, Th9, Th17 and Th22 contents as well as serum IL-4, IL-9, IL-10, TGF-β1, IL-17 and IL-22 contents of nutrition group were significantly lower than those of control group, and CyclinD1, Bcl-2, USP22, VEGF and N-cadherin mRNA expression were not different from those of control group.Conclusion:Nutritional support + intravenous chemotherapy can improve the anti-tumor immune response without affecting the proliferation of cancer cells in the lesion of patients with colon cancer complicated by incomplete intestinal obstruction.
文摘To study and analyze the case data of an elderly patient with cervical cancer complicated with intestinal obstruction and incision dehiscence after operation, to explore the risk factors of postoperative complications of elderly patients with cervical cancer, and to explore the key points of postoperative care and experience of such patients combined with clinical practice.
文摘Objective: to analyze the role of psychological nursing mode in the preoperative bowel clearing management of patients with colorectal cancer and intestinal obstruction. Methods: a total of 100 patients with colorectal cancer complicated with intestinal obstruction admitted to our hospital from March 2020 to February 2021 were included in the randomized group. The control group received routine preoperative intestinal irrigation management and had no difference with the seamless nursing model group. For nursing model, complications were compared between the two groups. Results: the incidence of postoperative infection and bleeding in the seamless nursing model group was lower than that in the control group. Conclusion: the smooth nursing mode and effect of patients with colorectal cancer and intestinal obstruction are accurate, can reduce complications, and is worthy of popularization and application.
文摘This study summarizes the nursing experience of a patient with active Crohn’s disease in the acute stage,complicated by small bowel obstruction.Key aspects of nursing include psychological response guidance during the active phase of Crohn’s disease,support before and after various gastroenteroscopy procedures and related reports,and self-monitoring guidance for symptoms such as intestinal obstruction combined with endoscopic mucosal ulcers.Using the 5A nursing model,nursing staff assessed the patient’s needs,provided targeted nursing recommendations in stages,implemented health behavior strategies,and offered continuous nursing care,including positive support for sexual health beliefs.These interventions helped the patient overcome psychological challenges,such as resistance to indwelling gastric tubes,and adopt healthy behaviors.After six weeks of follow-up through phone and WeChat consultations,the patient demonstrated significant improvement,including a weight gain of 15 kg.Various test results indicated normalized nutritional and inflammatory indexes,and the Crohn’s Disease Activity Index decreased by≥70 points.In conclusion,establishing a nursing team and applying the 5A nursing model to formulate detailed nursing diagnoses and interventions can significantly improve outcomes for patients with active Crohn’s disease complicated by small intestinal obstruction.
文摘Hepatic hemangiomas are the most common benign tumor of the liver.Most hepatic hemangiomas remain asymptomatic and require no treatment.Giant hepatic hemangiomas with established complications,diagnostic uncertainty and incapacitating symptoms,however,are generally considered an absolute indication for surgical resection.We present a case of a giant hemangioma with intestinal obstruction following transcatheter arterial embolization,by which the volume of the hemangioma was significantly reduced,and it was completely resected by a left hepatectomy.A 21-yearold Asian man visited our hospital for left upper quadrant pain.Examinations at the first visit revealed a left liver hemangioma occupying the abdominal cavity,with a maximum diameter of 31.5 cm.Embolization of the left hepatic artery was performed and confirmed a decrease in its size.However,the patient was readmitted to our hospital one month after embolization for intestinal obstruction.A left hepatectomy was completed through a herringbone incision,and safely removed a giant hemangioma of 26.5 cm × 19.5 cm × 12.0 cm in size and 3690 g in weight.Pre-operative arterial embolization is effective for reducing tumor size,but a close follow-up to decide the time for hepatectomy is important.
基金Supported by Higher Education Quality Project of Sichuan Province:Innovative Scientific Experiment Project of SichuanProvince,Grant No.SJCX201110Chengdu Medical College Innovative Scientific Experiment Project,Grant No.CX201220and CX201115
文摘AIM:To investigate different methods of creating incomplete intestinal obstruction in a rat model and to compare their electrophysiologic,morphologic and histologic characteristics. METHODS:Rat ileum was partially obstructed by the respective application of:braided silk(penetrated the mesentery and surrounded intestine);half ligation (penetrated directly and ligated 1/2 cross-section of the intestine);wide pipe(6 mm in width,surrounded the intestine);narrow pipe(2 mm in width,surrounded the intestine).A control was also included(no obstruction). Various behavioral and electrophysiologic variables, as well as morphologic and immunohistochemical observations were recorded by blinded investigators at different time points(12,24,48,72 h),including daily general condition,ileal wet weight and circumference, macromorphous and micromorphous intestine,bowel movement capability in vivo and in vitro,slow wave and neural electrical activity,and the number of c-Kit positive interstitial cells of Cajal(ICC). RESULTS:Despite being of a similar general condition, these methods resulted in different levels of obstruction in each group compared with the control at different time points(12,24,48,72 h).However,these fields of the wide pipe rat showed significantly differences when compared with the other three obstructed groups at 12 to 72 h,including macroscopic and histological presentation,intestinal transit ratio and contractility,circumference and wet weight,amplitude and frequency of nerve electrical discharge and slow wave,and ICC numbers(all P<0.01). CONCLUSION:The wide pipe rat method is significantly more reliable and stable than the other methods of obstruction,demonstrating that use of the wide pipe method can be a useful model of incomplete intestinal obstruction.
文摘AIM: To investigate the long-term follow-up of distal intestinal obstruction syndrome(DIOS) in Israeli cystic fibrosis(CF) patients.METHODS: This is a multi-center,comparative,retrospective study in which we reviewed the medical records of all CF patients from three major CF centers in Israel who were treated in the period from 1980 to 2012.Patients diagnosed with DIOS were defined as the study group.The patients were diagnosed with DIOS based on their clinical presentation and typical findings on either abdominal X-ray or computerized tomography scan.For the control group,CF patients with no DIOS were matched to the patients in the study group for age,sex,and cystic fibrosis transmembrane conductance regulator(CFTR) mutations.For both groups,the collected data included age,sex,CFTR genotype,weight,height,and body mass index.Clinical data included respiratory function tests in the last five years prior to the study,respiratory function test immediately before and after the DIOS event,number of hospitalizations,sputum culture results,and CFrelated conditions diagnosed according to the CF clinical practice guidelines.In the study group,data on the DIOS treatment and tendency for DIOS recurrence were also analyzed.RESULTS: The medical charts for a total of 350 CF patients were reviewed.Of the 350 CF patients,26(7.4%) were diagnosed with DIOS.The control group included 31 CF patients with no DIOS diagnosis.The mean follow-up period was 21.6 ± 8.2 years.The total of DIOS episodes in the follow-up period was 60.The distribution of DIOS episodes was as follows: 6/26(23.1%) study patients had one episode of DIOS intheir lifetime,7/26(26.9%) had two episodes,7/26(26.9%) had three episodes,and 6/26(23.1%) had four or more episodes.Compared to the control group,DIOS patients had a significantly higher incidence of meconium ileus in the past(65.4% vs 0%,respectively,P < 0.02),more Aspergillus spp.colonization(34.6% vs 3.2%,respectively,P < 0.02),and a higher number of hospitalizations due to respiratory exacerbations(8.6 vs 6.2 mean total hospitalizations per follow-up period,respectively,P < 0.02).No other significant differences were found between the control and study groups.The conservative treatment of DIOS,which mainly includes hydration and stool softeners,was successful in 82% of the episodes.The survival rate was similar for both groups.CONCLUSION: CF patients with DIOS suffer from recurrent hospitalizations and airway pathogen acquisition.Although recurrence of DIOS is common,conservative treatment is successful in most patients.
文摘Abdominal cocoon syndrome is a rare cause of intestinal obstruction with unknown etiology. Diagnosis of this syndrome, which can be summarized as the small intestine being surrounded by a fibrous capsule not containing the mesothelium, is difficult in the preoperative period. A 47-year-old male patient was referred to the emergency department with complaints of abdominal pain, nausea, and vomiting for two days. The abdominal computed tomography examination detected dilated small intestinal loops containing air-fluid levels clustered in the left upper quadrant of the abdomen and surrounded by a thick, saclike, contrast-enhanced membrane. During exploratory surgery, a capsular structure was identified in the upper left quadrant with a regular surface that was solid-fibrous in nature. Ab-dominal cocoon syndrome is a rarely seen condition, for which the preoperative diagnosis is difficult. The combination of physical examination and radiological signs, and the knowledge of "recurrent characteristics of the complaints" that can be learned by a careful history, may be helpful in diagnosis.
