Acta Scientific Clinical Case Reports

Case Report Volume 2 Issue 8

Early Laparoscopic Management in the Setting of Non-Complicated Obstructive Abdomen. Case Report

Xavier Guarderas C1*, Juan C Santillán A2, Stefany A Santamaría S2, Fernando Huilca L3, Edwin Caiza S3, Cristian Merino L3, David Narváez S3 and Claudia Delgado G4*

1Hospital Vozandes Quito, General Surgery Attending, Quito, Ecuador
2Hospital Vozandes Quito, PGY-4 General Surgery, Quito, Ecuador
3Hospital Vozandes Quito, PGY-3 General Surgery, Quito, Ecuador
4Hospital Vozandes Quito, Medical Resident, Quito, Ecuador

*Corresponding Author: Claudia Delgado G, Medical Doctor from Universidad Internacional del Ecuador, Facultad de Ciencias Médicas de la Salud y la Vida, Escuela de Medicina, Quito, Ecuador.

Received: July 14, 2021; Published: July 30, 2021

Citation: Claudia Delgado G., et al. “Early Laparoscopic Management in the Setting of Non-Complicated Obstructive Abdomen. Case Report". Acta Scientific Clinical Case Reports 2.8 (2021): 91-95.

Abstract

Importance: The adhesive small bowel obstruction (ASBO) is one of the most common causes for hospital admission to surgical service. About one of every six surgical emergencies is caused by ASBO. This pathology can cause high morbidity, generating long-stay hospitalizations, (an average of 8 days when conservative treatment is started), and between 20 - 30% of them will require surgical management. We present the early use of laparoscopy and adhesiolysis for ASBO in a 63-year-old patient who came to the emergency department with several abdominal surgical history.

   There is much controversy regarding the management in patients with the diagnosis of ASBO. Extensive bibliography advocates an initial clinical management due to its high- resolution rates (65 - 80%), however, ideal criteria for surgical management in these patients have not been defined, above all, the role of laparoscopy and the reduction of days of hospitalization related to this last procedure when is applied.

Conclusion and Relevance: The laparoscopic approach for ASBO is associated with better postoperative results, early oral feeding and a better quality of life in a short and long term. However, a correct patient selection for this procedure must be strict, because bowel manipulation and adhesiolysis can cause inadvertent injuries, increasing patient morbidity and mortality.

Keywords: Intestinal Obstruction; Laparoscopy; Tissue Adhesions

Bibliography

  1. Behman R., et al. “Association of Surgical Intervention for Adhesive Small-Bowel Obstruction With the Risk of Recurrence”. JAMA Surgery5 (2019): 413.
  2. Sebastian-Valverde E., et al. “The role of the laparoscopic approach in the surgical management of acute adhesive small bowel obstruction”. BMC Surgery1 (2019).
  3. Ten Broek R., et al. “Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group”. World Journal of Emergency Surgery1 (2018).
  4. Bower K., et al. “Small Bowel Obstruction”. Surgical Clinics of North America5 (2018): 945-971.
  5. Behman R., et al. “Laparoscopic Surgery for Small Bowel Obstruction”. Advances in Surgery1 (2018): 15-27.
  6. Hernandez M., et al. “The American Association for the Surgery of Trauma Severity Grade is valid and generalizable in adhesive small bowel obstruction”. Journal of Trauma and Acute Care Surgery2 (2018): 372-378.
  7. O'Leary M., et al. “Predictors of Ischemic Bowel in Patients with Small Bowel Obstruction”. The American Surgeon10 (2016): 992-994.
  8. Thornblade L., et al. “The Safety of Expectant Management for Adhesive Small Bowel Obstruction: A Systematic Review”. Journal of Gastrointestinal Surgery4 (2019): 846-859.
  9. Farinella E., et al. “Feasibility of laparoscopy for small bowel obstruction”. World Journal of Emergency Surgery1 (2009): 3.
  10. Martin D Zielinski and Patrick W Eiken. “Prospective, observational validation of a multivariate small-bowell obstruction model to predict the need for operative intervention”. Journal of the American Collage of Surgeons (2011): 1068-1076.
  11. Hernandez MC., et al. “The American Association for the Surgery of Trauma Severity Grade is valid and generalizable in adhesive small bowel obstruction”. The Journal of Trauma and Acute Care Surgery2 (2018): 372-378.
  12. Behman R., et al. “Laparoscopic Surgery for Adhesive Small Bowel Obstruction Is Associated With a Higher Risk of Bowel Injury: A Population-based Analysis of 8584 Patients”. Annals of Surgery3 (2017): 489-498.

Copyright: © 2021 Claudia Delgado G., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



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