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The Diagnosis of Strangulation and Incarceration of Intestines: Clinically and Using Biomarkers

Year 2015, Volume: 5 Issue: 2, 147 - 151, 05.03.2015
https://doi.org/10.16899/ctd.67701

Abstract

The primary cause of intestinal obstructions is postoperative adhesions. The other common causes are hernias, neoplasms, inflammatory bowel diseases and gallstones. The obstructions that are caused by adhesions resolve with medical therapy and does not require surgery. Strangulation of the intestines is the most frightening complication of obstruction. Which patients need urgent surgical intervention and who do not is an important issue because of the nature of the disease. Identifying clinical features of strangulation in intestinal obstruction may help detection of patients who require urgent intervention and get better outcomes.

 

References

  • Maglinte DDT, Heitkamp DE, Howard TJ ve ark. Current concepts in imaging of small bowel obstruction. Radiol Clin North Am 2003;41:263-283.
  • Burkill JC, Bell JRG, Healy JC. The utility of computed tomography in acute small bowel obstruction. Clin Radiol 2001;56:350-359.
  • Burge J, Abbas SM, Roadley G ve ark. Randomized controlled trial of Gastrografin in adhesive small bowel obstruction. ANZ J Surg. 2005;75: 672-674.
  • Kendrick ML. Partial small bowel obstruction: clinical issues and recent technical advances. Abdom Imaging 2009;34: 329-334.
  • Cox MR, Gunn IF, Eastman MC ve ark. The operative aetiology and types of adhesions causing small bowel obstruction. Aust N Z J Med 1993;63:848-852.
  • Mucha P Jr: Small intestinal obstruction. Surg Clin North Am 1987;67:597-620.
  • Hayanga AJ, Bass-Wilkins K, Bulkley GB. Current management of small-bowel obstruction. Advances in surgery 2005;39: 1-33.
  • Bizer LS, Leibling RW, Delany HM ve ark. Small-bowel obstruction: the role of nonoperative treatment in simple intestinal obstruction and predictive criteria for strangulation obstruction. Surgery 1981;89:407–13.
  • Ellis H. The clinical significance of adhesions: focus on intestinal obstruction. Eur J Surg. 1997;163:5.
  • Hayden GE, Sprouse KL. Bowel obstruction and hernia. Emerg Med Clin North Am. 2011;29(2):319-45.
  • Kulaylat MN, Doerr RJ. Small bowel obstruction. Editörler: Holzheimer RG, Mannick JA. Surgical Treatment: Evidence-Based and Problem-Oriented. Munich: Zuckschwerdt;2001.
  • Fevang BT, Jensen D, Svanes K ve ark. Early operation or conservative management of patients with small bowel obstruction? Eur J Surg 2002;168:475–81.
  • Nauta RJ. Advanced abdominal imaging is not required to exclude strangulation if complete small bowel obstructions undergo prompt laparotomy. J Am Coll Surg 2005;200:904–11.
  • Fevang BT, Fevang J, Stangeland L ve ark. Complications and death after surgical treatment of small bowel obstruction: a 35-year institutional experience. Ann Surg 2000;231(4):529–37.
  • Silen W, Hein MF, Goldman L. Strangulation obstruction of the small intestine. Arch Surg 1962;85:121–9.
  • Sarr MG, Bulkley GB, Zuidema GD. Preoperative recognition of intestinal strangulation obstruction. Prospective evaluation of diagnostic capability. Am J Surg 1983;145:176-82.
  • Jancelewicz T, Vu LT, Shawo AE, Yeh B, Gasper WJ, Harris HW. Predicting strangulated small bowel obstruction: an old problem revisited. J Gastrointest Surg 2009;13(1):93-9.
  • Evennett NJ, Petrov MS, Mittal A, Windsor JA. Systematic review and pooled estimates for the diagnostic accuracy of serological markers for intestinal ischemia. World J Surg 2009;33:1374-1383.
  • Kanda T, Tsukahara A, Ueki K ve ark. Diagnosis of ischemic small bowel disease by measurement of serum intestinal fatty acid-binding protein in patients with acute abdomen: a multicenter, observer-blinded validation study. J Gastroenterol 2011; 46: 492-500.
  • Van Oudheusden TR, Aerts BA, de Hingh IH, Luyer MD. Challenges in diagnosing adhesive small bowel obstruction. World J Gastroenterol 2013;21;19(43):7489-93.
  • Jakob SM, Merasto-Minkkinen M, Tenhunen JJ, Heino A, Alhava E, Takala J. Prevention of systemic hyperlactatemia during splanchnic ischemia. Shock 2000;14: 123-127.
  • Derikx JP, Luyer MD, Heineman E, Buurman WA. Noninvasive markers of gut wall integrity in health and disease. World J Gastroenterol 2010; 16:42:5272-5279.
  • Hompson JS, Bragg LE, West WW: Serum enzyme levels during intestinal ischemia. Ann Surg 1990; 211:369-373.
  • Graeber GM, O'Neil JF, Wolf RE, Wukich DK, Caffery PJ, Harman JW:Elevated levels of peritoneal serum creatine phosphokinase with strangulated small bowel obstruction. Arch Surg 1983;118:837-840.
  • Sarr MG, Bulkley GB, Zuidoma GD:Preoperative recognition of intestinal strangulation obstruction. Prospective evaluation of diagnotic capability. Am J Surg 1983; 145:176-182.
  • Acosta S, Nilsson TK, Björck M. D-dimer testing in patients with suspected acute thromboembolic occlusion of the superior mesenteric artery. Br J Surg 2004;91:991-4.
  • Icoz G, Makay O, Sozbilen M ve ark. Is D-dimer a predictor of strangulated intestinal hernia? World J Surg 2006;30:2165-9.
  • Akyildiz H, Akcan A, Ozturk A, Sozuer E, Kucuk C, Yucel A. D-dimer as a predictor of the need for laparotomy in patients with unclear non-traumatic acute abdomen. A preliminary study. Scand J Clin Lab Invest 2008;68(7): 612-7.
  • Akyildiz HY, Sözüer E, Akcan A ve ark. The value of D-dimer test in the diagnosis of patients with nontraumatic acute abdomen. Ulus Travma Acil Cerrahi Derg 2010;16(1):22-6.
  • Karimova A, Pinsky D. The endothelial response to oxygen deprivation: biology and clinical implications. Intensive Care Med 2001;27:19–31.
  • Acosta S, Nilsson TK, Malina J, Malina M: L-lactate after embolization of the superior mesenteric artery. J Surg Res 2007;143:320–328.
  • Sommer T, Larsen JF. Intraperitoneal and intraluminal microdialysis in the detection of experimental regional intestinal ischaemia. Br J Surg 2004;91:855–61.
  • Smith SM, Eng RH, Buccini F. Use of D-lactic acid measurements in the diagnosis of bacterial infections. J Infect Dis 1986; 154: 658-664.
  • Poeze M, Froon AH, Greve JW, Ramsay G. D-lactate as an early marker of intestinal ischaemia after ruptured abdominal aortic aneurysm repair. Br J Surg 1998; 85: 1221-1224.
  • Derikx JP, Luyer MD, Heineman E, Buurman WA. Non-invasive markers of gut wall integrity in health and disease. World J Gastroenterol 2010;16(42):5272-9.
  • Funaoka H, Kanda T, Fujii H. Intestinal fatty acid-binding protein (I-FABP) as a new biomarker for intestinal diseases. Rinsho Byori 2010;58(2):162-8.
  • Holmes JH 4th, Lieberman JM, Probert CB ve ark. Elevated intestinal fatty acid binding protein and gastrointestinal complications following cardiopulmonary bypass: a preliminary analysis. J Surg Res 2001;100:192-196.
  • Crenn P, Coudray-Lucas C, Thuillier F, Cynober L, Messing B. Postabsorptive plasma citrulline concentration is a marker of absorptive enterocyte mass and intestinal failure in humans. Gastroenterology 2000;119: 1496-1505.
  • Curis E, Crenn P, Cynober L. Citrulline and the gut. Curr Opin Clin Nutr Metab Care 2007;10: 620-626.
  • Van Noord D, Mensink PB, de Knegt RJ ve ark. Serum markers and intestinal mucosal injury in chronic gastrointestinal ischemia. Dig Dis Sci 2011;56(2):506-12.
  • Kendrick ML. Partial small bowel obstruction: clinical issues and recent technical advances. Abdom Imaging 2009;34: 329-334.
  • Catena F, Di Saverio S, Kelly MD ve ark. Bologna Guidelines for Diagnosis and Management of Adhesive Small Bowel Obstruction (ASBO): 2010 Evidence-Based Guidelines of the World Society of Emergency Surgery. World J Emerg Surg 2011;6:5.
  • Schmutz GR, Benko A, Fournier L ve ark. Small bowel obstruction: role and contribution of sonography. Eur Radiol 1997;7:1054-1058.
  • Jaffer U. Computed tomography for small bowel obstruction. Emerg Med J 2007;24:790-791.
  • Balthazar EJ, Liebeskind ME, Macari M. Intestinal ischemia in patients in whom small bowel obstruction is suspected: evaluation of accuracy, limitations and clinical implications of CT in diagnosis. Radiology 1997;205: 519–522.
  • Sheedy SP, Earnest IV F, Fletcher JG, Fidler JL, Hoskin TL. CT of small-bowel ischemia associated with obstruction in emergency department patients: diagnostic performance evaluation. Radiology 2006;241: 729–736.
  • Pothiawala, Sohil, and Apoorva Gogna. Early diagnosis of bowel obstruction and strangulation by computed tomography in emergency department. World J Emerg Med 2012;3.3: 227-231.

İnce Barsak Obstrüksiyonunda Strangülasyon-İnkarserasyon Ayrımı: Klinik ve Laboratuar Bulgular

Year 2015, Volume: 5 Issue: 2, 147 - 151, 05.03.2015
https://doi.org/10.16899/ctd.67701

Abstract

İnce barsak obstrüksiyonunun en sık sebebi postoperatif adezyonlardır. Diğer sık görülen nedenler herniler, neoplazmlar, inflamatuar barsak hastalıkları ve safra taşları gibi nedenlerdir. Adezyona bağlı tıkanıklıkların %80'i konservatif tedavi ile geriler ve cerrahi girişim gerektirmez. İntestinal strangülasyon ince barsak tıkanıklığının korkulan bir komplikasyonudur. Hangi hastaların acil cerrahi tedaviye ihtiyacı olduğu, hastalığın değişken  doğasından dolayı halen önemli bir konu olarak tartışılmaktadır. Barsak tıkanıklığında strangülasyon için  klinik tanısal kriterlerin belirlenmesi, müdahale gerektiren hastaların erkenden tanınmasını ve daha iyi klinik sonuçlar alınmasını sağlayacaktır.

 

References

  • Maglinte DDT, Heitkamp DE, Howard TJ ve ark. Current concepts in imaging of small bowel obstruction. Radiol Clin North Am 2003;41:263-283.
  • Burkill JC, Bell JRG, Healy JC. The utility of computed tomography in acute small bowel obstruction. Clin Radiol 2001;56:350-359.
  • Burge J, Abbas SM, Roadley G ve ark. Randomized controlled trial of Gastrografin in adhesive small bowel obstruction. ANZ J Surg. 2005;75: 672-674.
  • Kendrick ML. Partial small bowel obstruction: clinical issues and recent technical advances. Abdom Imaging 2009;34: 329-334.
  • Cox MR, Gunn IF, Eastman MC ve ark. The operative aetiology and types of adhesions causing small bowel obstruction. Aust N Z J Med 1993;63:848-852.
  • Mucha P Jr: Small intestinal obstruction. Surg Clin North Am 1987;67:597-620.
  • Hayanga AJ, Bass-Wilkins K, Bulkley GB. Current management of small-bowel obstruction. Advances in surgery 2005;39: 1-33.
  • Bizer LS, Leibling RW, Delany HM ve ark. Small-bowel obstruction: the role of nonoperative treatment in simple intestinal obstruction and predictive criteria for strangulation obstruction. Surgery 1981;89:407–13.
  • Ellis H. The clinical significance of adhesions: focus on intestinal obstruction. Eur J Surg. 1997;163:5.
  • Hayden GE, Sprouse KL. Bowel obstruction and hernia. Emerg Med Clin North Am. 2011;29(2):319-45.
  • Kulaylat MN, Doerr RJ. Small bowel obstruction. Editörler: Holzheimer RG, Mannick JA. Surgical Treatment: Evidence-Based and Problem-Oriented. Munich: Zuckschwerdt;2001.
  • Fevang BT, Jensen D, Svanes K ve ark. Early operation or conservative management of patients with small bowel obstruction? Eur J Surg 2002;168:475–81.
  • Nauta RJ. Advanced abdominal imaging is not required to exclude strangulation if complete small bowel obstructions undergo prompt laparotomy. J Am Coll Surg 2005;200:904–11.
  • Fevang BT, Fevang J, Stangeland L ve ark. Complications and death after surgical treatment of small bowel obstruction: a 35-year institutional experience. Ann Surg 2000;231(4):529–37.
  • Silen W, Hein MF, Goldman L. Strangulation obstruction of the small intestine. Arch Surg 1962;85:121–9.
  • Sarr MG, Bulkley GB, Zuidema GD. Preoperative recognition of intestinal strangulation obstruction. Prospective evaluation of diagnostic capability. Am J Surg 1983;145:176-82.
  • Jancelewicz T, Vu LT, Shawo AE, Yeh B, Gasper WJ, Harris HW. Predicting strangulated small bowel obstruction: an old problem revisited. J Gastrointest Surg 2009;13(1):93-9.
  • Evennett NJ, Petrov MS, Mittal A, Windsor JA. Systematic review and pooled estimates for the diagnostic accuracy of serological markers for intestinal ischemia. World J Surg 2009;33:1374-1383.
  • Kanda T, Tsukahara A, Ueki K ve ark. Diagnosis of ischemic small bowel disease by measurement of serum intestinal fatty acid-binding protein in patients with acute abdomen: a multicenter, observer-blinded validation study. J Gastroenterol 2011; 46: 492-500.
  • Van Oudheusden TR, Aerts BA, de Hingh IH, Luyer MD. Challenges in diagnosing adhesive small bowel obstruction. World J Gastroenterol 2013;21;19(43):7489-93.
  • Jakob SM, Merasto-Minkkinen M, Tenhunen JJ, Heino A, Alhava E, Takala J. Prevention of systemic hyperlactatemia during splanchnic ischemia. Shock 2000;14: 123-127.
  • Derikx JP, Luyer MD, Heineman E, Buurman WA. Noninvasive markers of gut wall integrity in health and disease. World J Gastroenterol 2010; 16:42:5272-5279.
  • Hompson JS, Bragg LE, West WW: Serum enzyme levels during intestinal ischemia. Ann Surg 1990; 211:369-373.
  • Graeber GM, O'Neil JF, Wolf RE, Wukich DK, Caffery PJ, Harman JW:Elevated levels of peritoneal serum creatine phosphokinase with strangulated small bowel obstruction. Arch Surg 1983;118:837-840.
  • Sarr MG, Bulkley GB, Zuidoma GD:Preoperative recognition of intestinal strangulation obstruction. Prospective evaluation of diagnotic capability. Am J Surg 1983; 145:176-182.
  • Acosta S, Nilsson TK, Björck M. D-dimer testing in patients with suspected acute thromboembolic occlusion of the superior mesenteric artery. Br J Surg 2004;91:991-4.
  • Icoz G, Makay O, Sozbilen M ve ark. Is D-dimer a predictor of strangulated intestinal hernia? World J Surg 2006;30:2165-9.
  • Akyildiz H, Akcan A, Ozturk A, Sozuer E, Kucuk C, Yucel A. D-dimer as a predictor of the need for laparotomy in patients with unclear non-traumatic acute abdomen. A preliminary study. Scand J Clin Lab Invest 2008;68(7): 612-7.
  • Akyildiz HY, Sözüer E, Akcan A ve ark. The value of D-dimer test in the diagnosis of patients with nontraumatic acute abdomen. Ulus Travma Acil Cerrahi Derg 2010;16(1):22-6.
  • Karimova A, Pinsky D. The endothelial response to oxygen deprivation: biology and clinical implications. Intensive Care Med 2001;27:19–31.
  • Acosta S, Nilsson TK, Malina J, Malina M: L-lactate after embolization of the superior mesenteric artery. J Surg Res 2007;143:320–328.
  • Sommer T, Larsen JF. Intraperitoneal and intraluminal microdialysis in the detection of experimental regional intestinal ischaemia. Br J Surg 2004;91:855–61.
  • Smith SM, Eng RH, Buccini F. Use of D-lactic acid measurements in the diagnosis of bacterial infections. J Infect Dis 1986; 154: 658-664.
  • Poeze M, Froon AH, Greve JW, Ramsay G. D-lactate as an early marker of intestinal ischaemia after ruptured abdominal aortic aneurysm repair. Br J Surg 1998; 85: 1221-1224.
  • Derikx JP, Luyer MD, Heineman E, Buurman WA. Non-invasive markers of gut wall integrity in health and disease. World J Gastroenterol 2010;16(42):5272-9.
  • Funaoka H, Kanda T, Fujii H. Intestinal fatty acid-binding protein (I-FABP) as a new biomarker for intestinal diseases. Rinsho Byori 2010;58(2):162-8.
  • Holmes JH 4th, Lieberman JM, Probert CB ve ark. Elevated intestinal fatty acid binding protein and gastrointestinal complications following cardiopulmonary bypass: a preliminary analysis. J Surg Res 2001;100:192-196.
  • Crenn P, Coudray-Lucas C, Thuillier F, Cynober L, Messing B. Postabsorptive plasma citrulline concentration is a marker of absorptive enterocyte mass and intestinal failure in humans. Gastroenterology 2000;119: 1496-1505.
  • Curis E, Crenn P, Cynober L. Citrulline and the gut. Curr Opin Clin Nutr Metab Care 2007;10: 620-626.
  • Van Noord D, Mensink PB, de Knegt RJ ve ark. Serum markers and intestinal mucosal injury in chronic gastrointestinal ischemia. Dig Dis Sci 2011;56(2):506-12.
  • Kendrick ML. Partial small bowel obstruction: clinical issues and recent technical advances. Abdom Imaging 2009;34: 329-334.
  • Catena F, Di Saverio S, Kelly MD ve ark. Bologna Guidelines for Diagnosis and Management of Adhesive Small Bowel Obstruction (ASBO): 2010 Evidence-Based Guidelines of the World Society of Emergency Surgery. World J Emerg Surg 2011;6:5.
  • Schmutz GR, Benko A, Fournier L ve ark. Small bowel obstruction: role and contribution of sonography. Eur Radiol 1997;7:1054-1058.
  • Jaffer U. Computed tomography for small bowel obstruction. Emerg Med J 2007;24:790-791.
  • Balthazar EJ, Liebeskind ME, Macari M. Intestinal ischemia in patients in whom small bowel obstruction is suspected: evaluation of accuracy, limitations and clinical implications of CT in diagnosis. Radiology 1997;205: 519–522.
  • Sheedy SP, Earnest IV F, Fletcher JG, Fidler JL, Hoskin TL. CT of small-bowel ischemia associated with obstruction in emergency department patients: diagnostic performance evaluation. Radiology 2006;241: 729–736.
  • Pothiawala, Sohil, and Apoorva Gogna. Early diagnosis of bowel obstruction and strangulation by computed tomography in emergency department. World J Emerg Med 2012;3.3: 227-231.
There are 47 citations in total.

Details

Primary Language English
Journal Section Review Article
Authors

Okan Aktürk

Yeliz Aktürk This is me

Erdinç Çetinkaya This is me

Publication Date March 5, 2015
Published in Issue Year 2015 Volume: 5 Issue: 2

Cite

APA Aktürk, O., Aktürk, Y., & Çetinkaya, E. (2015). The Diagnosis of Strangulation and Incarceration of Intestines: Clinically and Using Biomarkers. Çağdaş Tıp Dergisi, 5(2), 147-151. https://doi.org/10.16899/ctd.67701
AMA Aktürk O, Aktürk Y, Çetinkaya E. The Diagnosis of Strangulation and Incarceration of Intestines: Clinically and Using Biomarkers. J Contemp Med. May 2015;5(2):147-151. doi:10.16899/ctd.67701
Chicago Aktürk, Okan, Yeliz Aktürk, and Erdinç Çetinkaya. “The Diagnosis of Strangulation and Incarceration of Intestines: Clinically and Using Biomarkers”. Çağdaş Tıp Dergisi 5, no. 2 (May 2015): 147-51. https://doi.org/10.16899/ctd.67701.
EndNote Aktürk O, Aktürk Y, Çetinkaya E (May 1, 2015) The Diagnosis of Strangulation and Incarceration of Intestines: Clinically and Using Biomarkers. Çağdaş Tıp Dergisi 5 2 147–151.
IEEE O. Aktürk, Y. Aktürk, and E. Çetinkaya, “The Diagnosis of Strangulation and Incarceration of Intestines: Clinically and Using Biomarkers”, J Contemp Med, vol. 5, no. 2, pp. 147–151, 2015, doi: 10.16899/ctd.67701.
ISNAD Aktürk, Okan et al. “The Diagnosis of Strangulation and Incarceration of Intestines: Clinically and Using Biomarkers”. Çağdaş Tıp Dergisi 5/2 (May 2015), 147-151. https://doi.org/10.16899/ctd.67701.
JAMA Aktürk O, Aktürk Y, Çetinkaya E. The Diagnosis of Strangulation and Incarceration of Intestines: Clinically and Using Biomarkers. J Contemp Med. 2015;5:147–151.
MLA Aktürk, Okan et al. “The Diagnosis of Strangulation and Incarceration of Intestines: Clinically and Using Biomarkers”. Çağdaş Tıp Dergisi, vol. 5, no. 2, 2015, pp. 147-51, doi:10.16899/ctd.67701.
Vancouver Aktürk O, Aktürk Y, Çetinkaya E. The Diagnosis of Strangulation and Incarceration of Intestines: Clinically and Using Biomarkers. J Contemp Med. 2015;5(2):147-51.