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The research progress of acute small bowel perforation
- Source :
- Journal of Acute Disease, Vol 4, Iss 3, Pp 173-177 (2015)
- Publisher :
- Hainan Medical College. Published by Elsevier (Singapore) Pte Ltd.
-
Abstract
- This article reviews the various aetiologies of small bowel perforations and their management. In addition to the well-known aetiologies such as trauma, inflammation and circulatory disorders, several new causes of small bowel perforation have been described in recent years. The spectrum reaches from iatrogenic perforations during laparoscopic surgery or enteroscopies to drug-induced perforations with new anticancer agents. The management of small bowel perforations requires a concept consisting of the safe revision of the leaking bowel and the treatment of the peritonitis. Depending on the local situation and the condition of the patient, several treatment options are available. The surgical management of the bowel leak can range from a simple primary closure to a delayed restoration of bowel continuity. When the condition of the bowel or patient is frail, the risk of a failure of a closure or anastomosis is too high, and the exteriorization of the bowel defect as a primary measure is a safe option. The treatment of the peritonitis is also dependent on the condition of the patient and the local situation. Early stages of peritonitis can be treated by a simple peritoneal lavage, either performed by laparoscopy or laparotomy. Severe forms of peritonitis with multi-organ failure and an abdominal compartment syndrome need repeated peritoneal revisions. In such cases, the abdomen can only be closed temporarily. Different technical options are available in order to overcome the difficult care of these patients.
- Subjects :
- Laparoscopic surgery
medicine.medical_specialty
Leak
Abdominal compartment syndrome
medicine.diagnostic_test
business.industry
medicine.medical_treatment
lcsh:Medical emergencies. Critical care. Intensive care. First aid
Peritonitis
General Medicine
lcsh:RC86-88.9
Aetiologies
Anastomosis
medicine.disease
Surgery
Treatment
medicine.anatomical_structure
Laparotomy
medicine
Abdomen
Laparoscopy
business
Small bowel perforation
Subjects
Details
- Language :
- English
- ISSN :
- 22216189
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of Acute Disease
- Accession number :
- edsair.doi.dedup.....ade4f5181edaf923b5810a63c16b82d6
- Full Text :
- https://doi.org/10.1016/j.joad.2015.04.002