Small bowel obstruction: Difference between revisions
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==Treatment== | ==Treatment== | ||
Clinical practice guidelines address the treatment.<ref name="pmid18545135">{{cite journal |author=Diaz JJ, Bokhari F, Mowery NT, ''et al'' |title=Guidelines for management of small bowel obstruction |journal=J Trauma |volume=64 |issue=6 |pages=1651–64 |year=2008 |month=June |pmid=18545135 |doi=10.1097/TA.0b013e31816f709e |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?an=00005373-200806000-00042 |issn=}}</ref> | Clinical practice guidelines address the treatment.<ref name="pmid18545135">{{cite journal |author=Diaz JJ, Bokhari F, Mowery NT, ''et al'' |title=Guidelines for management of small bowel obstruction |journal=J Trauma |volume=64 |issue=6 |pages=1651–64 |year=2008 |month=June |pmid=18545135 |doi=10.1097/TA.0b013e31816f709e |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?an=00005373-200806000-00042 |issn=}}</ref> | ||
Various medications have been studied including magnesium oxide<ref name="pmid">{{cite journal |author= |title= |journal= |volume= |issue= |pages= |year= |pmid= |pmc=1277043 |doi= |url=http://www.cmaj.ca/cgi/pmidlookup?view=long&pmid=16275967 |issn=}}</ref>, octreotide / methylglucamine diatrizoate combination<ref name="pmid16311083">{{cite journal |author=Zhang Y, Gao Y, Ma Q, ''et al'' |title=Randomised clinical trial investigating the effects of combined administration of octreotide and methylglucamine diatrizoate in the older persons with adhesive small bowel obstruction |journal=Dig Liver Dis |volume=38 |issue=3 |pages=188–94 |year=2006 |month=March |pmid=16311083 |doi=10.1016/j.dld.2005.10.010 |url=http://linkinghub.elsevier.com/retrieve/pii/S1590-8658(05)00432-9 |issn=}}</ref> | |||
Administration of "water-soluble contrast did not reduce the need for surgical intervention" according to a [[meta-analysis]] by the [[Cochrnae Collaboration]].<ref name="pmid17636770">{{cite journal |author=Abbas S, Bissett IP, Parry BR |title=Oral water soluble contrast for the management of adhesive small bowel obstruction |journal=Cochrane Database Syst Rev |volume= |issue=3 |pages=CD004651 |year=2007 |pmid=17636770 |doi=10.1002/14651858.CD004651.pub3 |url=http://dx.doi.org/10.1002/14651858.CD004651.pub3 |issn=}}</ref> Others do not agree with this.<ref name="pmid18545135">{{cite journal |author=Diaz JJ, Bokhari F, Mowery NT, ''et al'' |title=Guidelines for management of small bowel obstruction |journal=J Trauma |volume=64 |issue=6 |pages=1651–64 |year=2008 |month=June |pmid=18545135 |doi=10.1097/TA.0b013e31816f709e |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?an=00005373-200806000-00042 |issn=}}</ref> | Administration of "water-soluble contrast did not reduce the need for surgical intervention" according to a [[meta-analysis]] by the [[Cochrnae Collaboration]].<ref name="pmid17636770">{{cite journal |author=Abbas S, Bissett IP, Parry BR |title=Oral water soluble contrast for the management of adhesive small bowel obstruction |journal=Cochrane Database Syst Rev |volume= |issue=3 |pages=CD004651 |year=2007 |pmid=17636770 |doi=10.1002/14651858.CD004651.pub3 |url=http://dx.doi.org/10.1002/14651858.CD004651.pub3 |issn=}}</ref> Others do not agree with this.<ref name="pmid18545135">{{cite journal |author=Diaz JJ, Bokhari F, Mowery NT, ''et al'' |title=Guidelines for management of small bowel obstruction |journal=J Trauma |volume=64 |issue=6 |pages=1651–64 |year=2008 |month=June |pmid=18545135 |doi=10.1097/TA.0b013e31816f709e |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?an=00005373-200806000-00042 |issn=}}</ref> | ||
Revision as of 21:54, 18 February 2009
In medicine, small bowel obstruction is intestinal obstruction of the small intestine.
Prognosis
CT scan findings of complete obstruction, dilated small bowel, or free fluid are associated with having subsequent surgery.[1]
"The appearance of water-soluble contrast in the colon on an abdominal X ray within 24 hours of its administration predicts resolution of an adhesive small bowel obstruction with a pooled sensitivity of 0.97, specificity of 0.96."[2]
Treatment
Clinical practice guidelines address the treatment.[3]
Various medications have been studied including magnesium oxide[4], octreotide / methylglucamine diatrizoate combination[5]
Administration of "water-soluble contrast did not reduce the need for surgical intervention" according to a meta-analysis by the Cochrnae Collaboration.[2] Others do not agree with this.[3]
References
- ↑ Kory Jones et al., “Can a computed tomography scoring system predict the need for surgery in small-bowel obstruction?,” The American Journal of Surgery 194, no. 6 (December 2007), http://dx.doi.org/10.1016/j.amjsurg.2007.09.020 (accessed November 15, 2007).
- ↑ 2.0 2.1 Abbas S, Bissett IP, Parry BR (2007). "Oral water soluble contrast for the management of adhesive small bowel obstruction". Cochrane Database Syst Rev (3): CD004651. DOI:10.1002/14651858.CD004651.pub3. PMID 17636770. Research Blogging.
- ↑ 3.0 3.1 Diaz JJ, Bokhari F, Mowery NT, et al (June 2008). "Guidelines for management of small bowel obstruction". J Trauma 64 (6): 1651–64. DOI:10.1097/TA.0b013e31816f709e. PMID 18545135. Research Blogging.
- ↑ "". PMC 1277043. [e]
- ↑ Zhang Y, Gao Y, Ma Q, et al (March 2006). "Randomised clinical trial investigating the effects of combined administration of octreotide and methylglucamine diatrizoate in the older persons with adhesive small bowel obstruction". Dig Liver Dis 38 (3): 188–94. DOI:10.1016/j.dld.2005.10.010. PMID 16311083. Research Blogging.