Aims and objectives
Small bowel obstruction (SBO) from either adhesion by previous abdominal surgery or malignancy can cause from simple abdominal pain its mild form,
to fatal condition such as bowel ischemia and sepsis in case of strangulation.
Decompression of gastrointestinal tract is the most important and effective way to treat the bowel obstruction without evidence of strangulation [1,
2].
Previously,
surgical approach was chosen to treat the bowel obstruction including SBO; with the development of instruments,
nastogastric tube (NGT) or nasointestinal or nasoenteric tubes have been introduced...
Methods and materials
From April 2010 to December 2013,
all 60 patients were requested to insert the long nasoenteric tubes (M 37,F 23; Mean age 61.6 ± 12.3).
The cause of SBO obstruction was postoperative adhesion (n=48; 19 from colectomy due to colon cancer,
15 from total or subtotal gastrectomy due to stomach cancer,
four from hysterectomy with salpingo-oophorectomy due to gynecologic malignancy,
two from cystectomy due to bladder cancer,
one from distal pancreatectomy due to pancreatic cancer,
seven from benign conditions) or peritoneal seeding (n=12; four from...
Results
For 18 patients from 50 patients who underwent successful insertion of a Miller-Abbot tube,
duration of treatment could not be evaluated because of surgery (n=8) before improvement of symptom and sign,
spontaneous or iatrogenic retraction (n=6),
malfunction (n=3),
and hopeless discharge (n=1).
For 32 with improvement of symptom and radiologic findings,
mean duration of tube indwelling was 7.6 ± 5.2 days (1~24days) (Fig 5,
6).
Two patients from 10 patients with insertion of an Ileus tube were excluded from the study because the patient passed...
Conclusion
Fluorosopy-guided insertion of nasoenteric tubes with guiding catheters and wires is a feasible way to place the tube past the pylorus and the Treitz ligament without noticeable complication and clinical disadvantage compared to conventional insertion technique.
References
1.
Plusczyk T,
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Chirurg 77:898–903.
doi: 10.1007/s00104-006-1237-9
2.
Shittu OB,
Gana JY,
Alawale EO,
Ogundiran TO Pattern of mechanical intestinal obstruction in Ibadan: a ten year review.
Afr J Med Med Sci 30:17–21.
3.
Fleshner PR,
Siegman MG,
Slater GI,
et al.
(1995) A prospective,
randomized trial of short versus long tubes in adhesive small-bowel obstruction.
Am J Surg 170:366–70.
4.
Wolfson PJ,
Bauer JJ,
Gelernt IM,
et al.
(1985) Use of the long tube in the management...