| Theme | Diagnosis and Treatment of Intestinal Obstruction: Timing in Consulting a Surgeon | |
|---|---|---|
| Title | Diagnosis of Strangulated Small Bowel Obstruction | |
| Publish Date | 2004/08 | |
| Author | Hideaki Takasaki | Department of Surgery 1, Nippon Medical School |
| Author | Takashi Tajiri | Department of Surgery 1, Nippon Medical School |
| Author | Hiroyuki Tsuruta | Department of Surgery 1, Nippon Medical School |
| [ Summary ] | We demonstrated four cases of strangulated small bowel obstruction (SBO), and mentioned important points concerning differential diagnoses between adhesive SBO and strangulated SBO. In strangulated SBO, there are two types of clinical symptoms, one with typical severe abdominal pain and shock, the other with milder symptoms which is difficult to differentially diagnose as adhesive SBO. The later cases tend to be treated conservatively at first. To know when to consult surgeons, physician should pay attention to the following signs; (1) Severe abdominal pain ineffective treated with anodyne. (2) Massive ascites seen in CT scans or ultrasonography. (3) Mesenterial abnormalities, such as excessive extension or mesenteric whirl formations. (4) The presence of non-enhanced bowel walls, seen in enhanced CT scans. (5) In conservative therapy, the amount of discharge from decompression tubes provides valuable information. Without resolution of SBO, a decrease in the amount of discharge suggests the presence of a closed loop. These signs strongly suggest the presence of strangulated SBO. |
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