Small bowel obstruction due to congenital adhesion bands in the virgin abdomen. There is more than meets the eye.

IF 0.9 4区 医学 Q3 SURGERY
Annali italiani di chirurgia Pub Date : 2023-09-05
Athanasia Mitsala, Konstantinos Romanidis, Michail Pitiakoudis
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引用次数: 0

Abstract

Introduction: Adhesive small bowel obstruction (SBO) represents a common surgical emergency leading to increased hospital admissions. Most patients presenting with adhesive SBO have a history of previous abdominal surgery. Although bowel obstruction secondary to congenital adhesion bands is rare, it should not be ruled out even in patients with a "virgin abdomen".

Case report: We present two rare cases of adult patients with SBO due to congenital adhesions. The first patient was transferred to the operating room, secondary to a closed-loop obstruction diagnosis. Two congenital adhesion bands were detected intraoperatively, then coagulated and divided. The second patient was surgically treated due to worsening abdominal pain. An adhesive band was identified occluding the ileum on surgical exploration, then ligated and excised. Both patients recovered uneventfully, without any recurrence of symptoms on the follow-up.

Discussion: Single adhesive bands are more commonly found in cases with a "virgin abdomen". Meanwhile, solitary bands usually lead to bowel strangulation and ischemia, mostly mandating operative management. Interestingly, a computed tomography scan may confirm the diagnosis of bowel obstruction, whereas water-soluble contrast agents may help predict the need for surgical treatment. Besides exploratory laparotomy, laparoscopic surgery is gaining ground as an effective SBO diagnosis and management approach.

Conclusion: Adhesive SBO due to congenital bands is a rare condition, particularly in adults, with potentially lifethreatening complications. With the aim of prompt diagnosis and treatment, a high index of suspicion and awareness should be maintained even in patients without previous medical or surgical history.

Key words: Small bowel obstruction, Congenital adhesion bands, Virgin abdomen.

处女腹部先天性粘连带引起的小肠梗阻。有比表面上看到的更多。
引言:粘连性小肠梗阻(SBO)是一种常见的外科紧急情况,导致住院人数增加。大多数出现粘连性SBO的患者都有腹部手术史。尽管先天性粘连带继发性肠梗阻很少见,但即使是“处女腹部”患者也不应排除这种情况。病例报告:我们报告了两例罕见的成人先天性粘连性SBO患者。第一名患者被转移到手术室,进行闭环梗阻诊断。术中发现两条先天性粘连带,然后进行凝固和分割。第二名患者因腹痛加重接受了手术治疗。在手术探查中发现一条粘连带堵塞回肠,然后结扎并切除。两名患者均顺利康复,在随访中没有任何症状复发。讨论:单胶带更常见于“处女腹部”病例。同时,孤立带通常会导致肠绞杀和局部缺血,大多需要手术治疗。有趣的是,计算机断层扫描可以确认肠梗阻的诊断,而水溶性造影剂可以帮助预测手术治疗的需要。除了剖腹探查外,腹腔镜手术作为一种有效的SBO诊断和管理方法也越来越受到重视。结论:先天性束带引起的粘连性SBO是一种罕见的情况,尤其是在成人中,可能会出现危及生命的并发症。为了及时诊断和治疗,即使在没有既往病史或手术史的患者中,也应保持高度的怀疑和意识。关键词:小肠梗阻,先天性粘连带,圣母腹部。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.90
自引率
12.50%
发文量
116
审稿时长
>12 weeks
期刊介绍: Annali Italiani di Chirurgia is a bimonthly journal and covers all aspects of surgery:elective, emergency and experimental surgery, as well as problems involving technology, teaching, organization and forensic medicine. The articles are published in Italian or English, though English is preferred because it facilitates the international diffusion of the journal (v.Guidelines for Authors and Norme per gli Autori). The articles published are divided into three main sections:editorials, original articles, and case reports and innovations.
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