Surgical treatment of intestinal obstruction with secondary peritonitis
DOI:
https://doi.org/10.11603/2414-4533.2026.2.16146Keywords:
intestinal obstruction, anastomotic leak after intestinal surgery, secondary peritonitis, surgical treatmentAbstract
The aim of the work: to improve the results of treatment of patients with intestinal obstruction complicated by secondary peritonitis by improving tactical and therapeutic approaches based on the study of indicators of endogenous intoxication and hepatic dysfunction.
Materials and Methods. The results of treatment of 131 patients with intestinal obstruction complicated by secondary peritonitis were analyzed. All patients underwent a comprehensive clinical and laboratory examination. The severity of endotoxicosis was determined taking into account changes in the leukocyte formula, the leukocyte intoxication index, the levels of middle-molecular-weight molecules, lipid peroxidation products – malonaldehyde, diene conjugates, indicators of antioxidant protection – activity of catalase enzymes, ceruloplasmin, iron saturation of transferrin and the state of microelement homeostasis.
Results. It was found that the use of hepatoprotective and antioxidant therapy allowed to reduce the duration of nasointestinal intubation in both main groups from (5.3±0.52) days in the control group to (4.1±0.40) days (1.29 times) – in patients of the first main group and (3.8±0.38) days (1.39 times) – in patients of the second main group. The initial severity of the patients' condition on the first day after surgical treatment in the comparison group was (18.0±2.43) points, in the main groups: I – (17.9±2.51) and II – (18.0±2.54) points. During the treatment, on the second day, the severity of the condition of the patients in the control group was (17.9±2.59) points, while in the first main group – (17.0±3.54), in the second main group – (16.7±2.32) points. On the 5th day, respectively, (15.3±2.36) points and (14.1±2.61) and (13.0±2.51) points, on the seventh day – (12.7±1.64); (12.0±1.67) and (11.8±1.51) points (p>0.05).
Conclusions. The use of the proposed approach made it possible to reduce the duration of inpatient treatment by 12.2 % in the first main group of patients and decrease the mortality rate to 2.29 %.
References
Walshaw J, Smith HG, Lee MJ. Small bowel obstruction. Br J Surg. 2024; 111(7):znae167. DOI: 10.1093/bjs/znae167. DOI: https://doi.org/10.1093/bjs/znae167
Shen CJ, Wang JJ. Advancements in the clinical management of adhesive small bowel obstruction: a perspective. Medicine (Baltimore). 2025; 104(27):e43246. DOI: 10.1097/MD.0000000000043246. DOI: https://doi.org/10.1097/MD.0000000000043246
Ling XS, Tian WCAB, Augustin G, Catena F. Can small bowel obstruction during pregnancy be treated with conservative management? World J Emerg Surg. 2024; 19:13. DOI: 10.1186/s13017-024-00541-y. DOI: https://doi.org/10.1186/s13017-024-00541-y
Choy KT, Le KDR, Kong JCH. Seprafilm and adhesive small bowel obstruction in colorectal surgery: an updated systematic review. BMC Surg. 2024; 24:291. DOI: 10.1186/s12893-024-02581-2. DOI: https://doi.org/10.1186/s12893-024-02581-2
Loison M, Bouhours G, Fabulas F, Bougard M, Delestre M, Parot-Schinkel E, et al. Enhanced recovery programs following adhesive small bowel obstruction surgery reduce postoperative ileus. Langenbecks Arch Surg. 2024; 409:191. DOI: 10.1007/s00423-024-03389-7. DOI: https://doi.org/10.1007/s00423-024-03389-7
Sinicropi T, Mazzeo C, Sofia C, Biondo SA, Cucinotta E, Fleres F. Acute chyloperitoneum with small bowel volvulus: case series and systematic review. J Clin Med. 2024; 13(10):2816. DOI: 10.3390/jcm13102816. DOI: https://doi.org/10.3390/jcm13102816
Mert A, Yurdakul-Deniz F. Determining the need for surgery in small bowel obstruction using clinical and radiological parameters. Cir Cir. 2024; 92(4):487-94. DOI: 10.24875/CIRU.23000586. DOI: https://doi.org/10.24875/CIRUE.M23000692
Mangla M, Ramavath K, Kumar N, Roy S, Srirambhatla A, Palo S. Ovarian cystadenofibroma causing small bowel obstruction and perforation peritonitis. J Midlife Health. 2024; 15(1):43-7. DOI: 10.4103/jmh.jmh_5_24. DOI: https://doi.org/10.4103/jmh.jmh_5_24
Lee C, Antoun I. Post-appendicectomy small bowel obstruction due to internal hernia involving Meckel’s diverticulum. BMJ Case Rep. 2024; 17(2):e257717. DOI: 10.1136/bcr-2023-257717. DOI: https://doi.org/10.1136/bcr-2023-257717
Hasnaoui A, Trigui R, Heni S, Ramdass P. Abdominal cocoon: a rare cause of small bowel obstruction. Int J Surg Case Rep. 2023; 111:108897. DOI: 10.1016/j.ijscr.2023.108897. DOI: https://doi.org/10.1016/j.ijscr.2023.108897
Aloraini A, Aljomah N, AlMogbel G, Alamri H. Sclerosing encapsulating peritonitis presenting as small bowel obstruction. Int J Surg Case Rep. 2023; 107:108201. DOI: 10.1016/j.ijscr.2023.108201. DOI: https://doi.org/10.1016/j.ijscr.2023.108201
DuBois SM, Alexander RM, Naumova AD, To JQ. Small bowel obstruction secondary to endometriosis and hydrosalpinx. Am Surg. 2023; 89(8):3560-62. DOI: 10.1177/00031348231161705. DOI: https://doi.org/10.1177/00031348231161705
Mare H, Tjhin W. Successful laparoscopic management of pericaecal hernia causing small bowel obstruction. Cureus. 2023; 15(2):e34663. DOI: 10.7759/cureus.34663. DOI: https://doi.org/10.7759/cureus.34663
Yang L, Kao L. Small bowel obstruction after vaginal delivery due to adhesions. Case Rep Obstet Gynecol. 2023; 2023:6563205. DOI: 10.1155/2023/6563205. DOI: https://doi.org/10.1155/2023/6563205
Najm M, Kelzia A, Arnaout I, Kadoura L, Ghazal A. Small bowel obstruction caused by Meckel’s diverticulum. J Surg Case Rep. 2023; 2023(6):rjad332. DOI: 10.1093/jscr/rjad332. DOI: https://doi.org/10.1093/jscr/rjad332
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