Annals of Coloproctology

Original Articles

Benign GI diease

Factors Predicting the Need for Early Surgical Intervention for Small Bowel Obstruction: Young Jae Cho, In Seok Park, Jungbin Kim, Hyun Jin Cho, Geum Hee Gwak, Keun Ho Yang, Byung Noe Bae, Ki Hwan Kim; Ann Coloproctol. 2020;36(4):223-228. Published online January 31, 2020; DOI: https://doi.org/10.3393/ac.2019.09.30

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Purpose
Small bowel obstruction (SBO) is a common disease that requires hospitalization. The most common cause of SBO is postoperative adhesion. Delayed timing of operations in patients who need surgical intervention results in mortality or morbidity. A number of studies on SBO have established criteria for emergency surgery. However, few objective clinical parameters are available for screening patients who need a delayed operation. Therefore, we analyzed factors that affect the clinical course of SBO to select appropriate therapeutic plans for reducing the risk of complications in these patients.
Methods
We investigated the clinical characteristics of patients admitted to the surgery department of our hospital between January 1, 2015, and December 31, 2016, who were diagnosed with SBO. Patients were divided into an operative treatment group (n = 12) and a conservative treatment group (n = 96). We compared clinical characteristics between the 2 groups.
Results
The operative treatment group underwent more operations before SBO than the conservative treatment group (P = 0.007). Initial leukocyte counts (P = 0.004) and C-reactive protein (CRP) levels (P = 0.028) were elevated in the operative group. Body mass index (BMI) was lower in the operative group (P = 0.013).
Conclusion
The number of operations before SBO, leukocyte counts, CRP levels, and BMI were useful parameters for selecting patients who needed an urgent operation for SBO.

Citations

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The predictive role of computed tomography with oral contrast in the successful management of adhesive small bowel obstruction
Mohamed Khattab, Amr Ayad, Sameh Aziz, Peter Alaa, Marie N. Grace, Mohamed Saber
The Egyptian Journal of Surgery.2024; 43(1): 16. CrossRef
Predictive factors for operative intervention and ideal length of non-operative trial in adhesive small bowel obstruction
Tara van Veen, Purushotham Ramanathan, Lolita Ramsey, Jonathan Dort, Dina Tabello
Surgical Endoscopy.2023; 37(11): 8628. CrossRef
Surgical management of adhesive small bowel obstruction: Is it still mandatory to wait? – An update
R. Demessence, Y. Lyoubi, F. Feuerstoss, A. Hamy, C. Aubé, A. Paisant, A. Venara
Journal of Visceral Surgery.2022; 159(4): 309. CrossRef
Prise en charge chirurgicale des syndromes occlusifs de l’intestin grêle sur bride et adhérences postopératoires : faut-il toujours attendre ?
R. Demessence, Y. Lyoubi, F. Feuerstoss, A. Hamy, C. Aubé, A. Paisant, A. Venara
Journal de Chirurgie Viscérale.2022; 159(4): 326. CrossRef
Small bowel obstruction
David J. Detz, Jerica L. Podrat, Jose C. Muniz Castro, Yoon K. Lee, Feibi Zheng, Shawn Purnell, Kevin Y. Pei
Current Problems in Surgery.2021; 58(7): 100893. CrossRef

Small Bowel Obstruction After Ileal Pouch-Anal Anastomosis With a Loop Ileostomy in Patients With Ulcerative Colitis: Hitoshi Kameyama, Yoshifumi Hashimoto, Yoshifumi Shimada, Saki Yamada, Ryoma Yagi, Yosuke Tajima, Takuma Okamura, Masato Nakano, Kohei Miura, Masayuki Nagahashi, Jun Sakata, Takashi Kobayashi, Shin-ichi Kosugi, Toshifumi Wakai; Ann Coloproctol. 2018;34(2):94-100. Published online April 30, 2018; DOI: https://doi.org/10.3393/ac.2017.06.14

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Abstract PDF

Purpose
Small bowel obstruction (SBO) remains a common complication after pelvic or abdominal surgery. However, the risk factors for SBO in ulcerative colitis (UC) surgery are not well known. The aim of the present study was to clarify the risk factors associated with SBO after ileal pouch-anal anastomosis (IPAA) with a loop ileostomy for patients with UC.
Methods
The medical records of 96 patients who underwent IPAA for UC between 1999 and 2011 were reviewed. SBO was confirmed based on the presence of clinical symptoms and radiographic findings. The patients were divided into 2 groups: the SBO group and the non-SBO group. We also analyzed the relationship between SBO and computed tomography (CT) scan image parameters.
Results
The study included 49 male and 47 female patients. The median age was 35.5 years (range, 14–72 years). We performed a 2- or 3-stage procedure as a total proctocolectomy and IPAA for patients with UC. SBO in the pretakedown of the loop ileostomy after IPAA occurred in 22 patients (22.9%). Moreover, surgical intervention for SBO was required for 11 patients. In brief, closure of the loop ileostomy was performed earlier than expected. A multivariate logistic regression analysis revealed that the 2-stage procedure (odds ratio, 2.850; 95% confidence interval, 1.009–8.044; P = 0.048) was a significant independent risk factor associated with SBO. CT scan image parameters were not significant risk factors of SBO.
Conclusion
The present study suggests that a 2-stage procedure is a significant risk factor associated with SBO after IPAA in patients with UC.

Citations

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Risk Factors for Stoma Outlet Obstruction after Proctocolectomy for Ulcerative Colitis
Keisuke Ihara, Takatoshi Nakamura, Masashi Takayanagi, Junki Fujita, Yasunori Maeda, Yusuke Nishi, Norisuke Shibuya, Hiroyuki Hachiya, Mitsuru Ishizuka, Keiichi Tominaga, Kazuyuki Kojima, Atsushi Irisawa
Journal of the Anus, Rectum and Colon.2024; 8(1): 18. CrossRef
Association Between Advanced T Stage and Thick Rectus Abdominis Muscle and Outlet Obstruction and High-Output Stoma After Ileostomy in Patients With Rectal Cancer
Yasuhiro Komatsu, Kunitoshi Shigeyasu, Sho Takeda, Yoshiko Mori, Kazutaka Takahashi, Nanako Hata, Kokichi Miyamoto, Hibiki Umeda, Yoshihiko Kakiuchi, Satoru Kikuchi, Shuya Yano, Shinji Kuroda, Yoshitaka Kondo, Hiroyuki Kishimoto, Fuminori Teraishi, Masahi
International Surgery.2022; 106(3): 102. CrossRef
Obstructive and secretory complications of diverting ileostomy
Shingo Tsujinaka, Hideyuki Suzuki, Tomoya Miura, Yoshihiro Sato, Chikashi Shibata
World Journal of Gastroenterology.2022; 28(47): 6732. CrossRef
Risk factors and management of stoma-related obstruction after laparoscopic colorectal surgery with diverting ileostomy
Ryo Maemoto, Shingo Tsujinaka, Yasuyuki Miyakura, Rintaro Fukuda, Nao Kakizawa, Tsutomu Takenami, Erika Machida, Nozomi Kikuchi, Rina Kanemitsu, Sawako Tamaki, Hideki Ishikawa, Toshiki Rikiyama
Asian Journal of Surgery.2021; 44(8): 1037. CrossRef
RISK FACTORS FOR THE DEVELOPMENT OF COMPLICATIONS OF ILEAL POUCH IN PATIENTS WITH ULCERATIVE COLITIS
S. I. Achkasov, O. I. Sushkov, A. E. Kulikov, Sh. A. Binnatli, M. A. Nagudov, A. V. Vardanyan
Koloproktologia.2020; 19(1): 51. CrossRef
A Common Complication After an Ileal Pouch-Anal Anastomosis With a Loop Ileostomy in Patients With Ulcerative Colitis: Small Bowel Obstruction
Chang-Nam Kim
Annals of Coloproctology.2018; 34(2): 57. CrossRef
Elevated risk of stoma outlet obstruction following colorectal surgery in patients undergoing ileal pouch–anal anastomosis: a retrospective cohort study
Satoshi Okada, Keisuke Hata, Shigenobu Emoto, Koji Murono, Manabu Kaneko, Kazuhito Sasaki, Kensuke Otani, Takeshi Nishikawa, Toshiaki Tanaka, Kazushige Kawai, Hiroaki Nozawa
Surgery Today.2018; 48(12): 1060. CrossRef

Risk Factors of Early Postoperative Small Bowel Obstruction Following a Proctectomy for Rectal Cancer: Jin Yong Shin; J Korean Soc Coloproctol. 2011;27(6):315-321. Published online December 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.6.315

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Abstract PDF

Purpose

Postoperative small bowel obstruction is a common and serious complication following a proctectomy, and early postoperative small bowel obstruction (EPSBO) leads to longer hospital stays, delays chemotherapy in advanced cases, and may be a contributor to mortality. The goal of this study is to identify the risk factors of EPSBO after a proctectomy for rectal cancer, thereby seeking to reduce the incidence of EPSBO.

Methods

Patients (735) who underwent a proctectomy for rectal cancer between March 2005 and February 2010 were entered into this study, and data were collected prospectively. Patients were judged to have EPSBO if, within the first 30 days, they presented symptoms such as nausea, vomiting and abdominal distention lasting for 2 days, and radiologic finding of small bowel obstruction after evidence of return of small bowel motility. The association between EPSBO and patients and surgery-related variables were studied by using univariate and multivariate analyses.

Results

EPSBO developed in 47 cases (6.4%) and was the most frequently occurring complication in the early perioperative period following a proctectomy. The frequency of EPSBO according to operative variables shows that EPSBO developed in 3.0% of the patients who underwent laparoscopic surgery (LS) compared with 8.4% of the patients who underwent open surgery (OS) (P = 0.004). OS (odds ratio [OR], 2.5) and a previous laparotomy (OR, 2.3) were independent risk factors for the development of EPSBO after a proctectomy for rectal cancer.

Conclusion

EPSBO is more likely to occur in patients who undergo OS or who have had a previous laparotomy. LS may be considered as a surgical procedure that can reduce the risk of EPSBO in patients undergoing a proctectomy for rectal cancer.

Citations

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Median and medial umbilical ligament repositioning for prevention of pelviperineal complications following abdominoperineal resection—a case series and novel technique
Anand Thomas, Subi TS, Teena Sleeba, Abhijith Antony, Naveen George
Langenbeck's Archives of Surgery.2024;[Epub] CrossRef
Establishing and clinically validating a machine learning model for predicting unplanned reoperation risk in colorectal cancer
Li-Qun Cai, Da-Qing Yang, Rong-Jian Wang, He Huang, Yi-Xiong Shi
World Journal of Gastroenterology.2024; 30(23): 2991. CrossRef
Optimized machine learning model for predicting unplanned reoperation after rectal cancer anterior resection
Yang Su, Yanqi Li, Wangshuo Yang, Xuelai Luo, Lisheng Chen
European Journal of Surgical Oncology.2024; 50(12): 108703. CrossRef
Omental Pedicle Flap Does Not Decrease the Incidence of Bowel Obstruction after Abdominoperineal Resection
Kunal Kochar, Slawomir Marecik, Leela M. Prasad, John Park
The American Surgeon™.2016; 82(11): 328. CrossRef
Early Postoperative Small Bowel Obstruction is an Independent Risk Factor for Subsequent Adhesive Small Bowel Obstruction in Patients Undergoing Open Colectomy
Soo Young Lee, Kyu Joo Park, Seung‐Bum Ryoo, Heung‐Kwon Oh, Eun Kyung Choe, Seung Chul Heo
World Journal of Surgery.2014; 38(11): 3007. CrossRef

Case Report

A Case of Small Bowel Obstruction Due to a Paracecal Hernia: Eun-Jung Jang, Seung Hyun Cho, Dae-Dong Kim; J Korean Soc Coloproctol. 2011;27(1):41-43. Published online February 28, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.1.41

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Abstract PDF

Internal hernias are rare causes of small bowel obstruction, and one such internal hernia is the paracecal hernia. We report a case of a small bowel obstruction related to a paracecal hernia in which a preoperative diagnosis was made on computed tomography. A laparotomy was performed for definitive diagnosis and treatment. The surgery achieved a good outcome.

Citations

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Surgical Management of Pericaecal Hernia in a Virgin Abdomen
Jia Ling Ong, Wei Chuan Tan, Kien Fatt Sean Lee, Kuan Yuen Yeong, Choon Sheong Seow
Cureus.2024;[Epub] CrossRef
Internal Hernia Through a Congenital Defect in Broad Ligament: A Rare and Elusive Cause of Intestinal Obstruction
Partha Nandi, Sudhir Jain, Akhil Kainth, Shivani Atri
Cureus.2022;[Epub] CrossRef
Ruptured Ovarian Cyst Masking Diagnosis of Hernia Through Broad Ligament of Uterus: A Case Report
Pankaj Agrawal, John T. Grab, Harold R. Howe, Kimberly Cross
Journal of Investigative Medicine High Impact Case Reports.2022;[Epub] CrossRef
“PRIMARY INTERNAL HERNIA IN ADULT: A RARE CASE OF ACUTE ABDOMEN”.
Pooja Pandey, Abhishek Ghosh, Abhishek Ranjan, Shyamendra Pratap Sharma
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH.2022; : 60. CrossRef
Uncommon presentation of small bowel pericaecal hernia in an octogenarian
Balakrishnan Gurumurthi, William Luffman, Mutee Rehman, Taher Fatayer, Abhiram Sharma
ANZ Journal of Surgery.2021; 91(3): 467. CrossRef
Heterogeneity of internal hernia post anterior resection: a missed diagnosis
Anshini Jain, Suat Chin Ng, Nicholas Savage, Daniel Lamanna, Satish Warrier, Phil Smart
ANZ Journal of Surgery.2021;[Epub] CrossRef
Laparoscopic management of a small bowel obstruction caused by an unusual pericecal hernia: Case report
Abdullah J. AlShehri, Mohannad A. Alsofyani, Bander Al Omeyr, Marwan Amin Abufara, Ali Mohammed Alzahrani, Rami Abdulrahman Sairafi
International Journal of Surgery Case Reports.2021; 81: 105825. CrossRef
Laparoscopic management of strangulated paracaecal hernia causing small bowel obstruction. Case report and review of the literature
Mahmoud Al-Ardah, Heena Sisodia, Hannah Rottenburg, Michael Clarke
Journal of Surgical Case Reports.2021;[Epub] CrossRef
Successful Retrocecal Hernia Diagnosis and Treatment: A Case Report
Masaaki Shida, Masayuki Tanaka, Toshiya Tanaka, Yoshihiko Kitajima, Seiji Sato
International Surgery.2021; 105(1-3): 469. CrossRef
Small bowel obstruction caused by pericaecal hernia resolved with a laparoscopic approach
K Plua-Muñiz, J Sanchez-Gonzalez, M Bailon-Cuadrado, D Pacheco-Sanchez
The Annals of The Royal College of Surgeons of England.2020; 102(7): e155. CrossRef
Post-trauma transmesocolic hernia: a case report
Doaa Hussin Salam, Mohannad Al-Tarakji, Abubaker Ibrahim Alaieb, Rajvir Singh, Ayman El-Menyar, Hassan Al-Thani, Ahmad Zarour, Mohamed Ellabib
Journal of Surgical Case Reports.2020;[Epub] CrossRef
HERNIATION THROUGH LESSER SAC: A RARE TYPE OF PRIMARY INTERNAL HERNIA CAUSING SMALL INTESTINAL OBSTRUCTION
Pritam Kar, Ranjan George Baxla, Abhishek Kushwaha, Anup Kumar Mahato
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH.2020; : 1. CrossRef
Paracaecal hernia: uncommon but important cause of small bowel obstruction successfully managed with laparoscopic surgery
Daryl K. A. Chia, Kon V. Tay, Alfred Kow, Jimmy So, Asim Shabbir, Guowei Kim
ANZ Journal of Surgery.2019; 89(6): 769. CrossRef
Paracecal hernia due to membranous adhesion of the omentum to the right paracolic gutter
Taro Yokota, Kazuhiro Otani, Junichi Yoshida, Naoki Mochidome, Eiji Miyatake, Chihiro Nakahara, Toshiyuki Ishimitsu, Masao Tanaka
Surgical Case Reports.2019;[Epub] CrossRef
Pericecal herniation of sigmoid colon diagnosed by computed tomography
Ji Eun Lee, Seo-Youn Choi, Min Hee Lee, Boem Ha Yi, Hae Kyung Lee, Bong Min Ko
Medicine.2018; 97(27): e11336. CrossRef
Strangulated Small Bowel Obstruction in Paracecal Hernia and Laparoscopic Approach: A Case Report and Review of Literature
Stefano Mandalà, Antonino Mirabella, Massimo Lupo, Massimo Branca, Camillo La Barbera, Carlo Szokoll, Vincenzo Mandalà
Annals of Colorectal Research.2018;[Epub] CrossRef
Incarcerated pericecal hernia: a rare form of the internal hernia
Sung Il Kang
Yeungnam University Journal of Medicine.2018; 35(2): 236. CrossRef
Retrocecal hernia preoperatively diagnosed by computed tomography: A case report
Shingo Ito, Ryohei Takeda, Ritsuo Kokubo, Yoshio Sakai, Hirokazu Matsuzawa, Kiichi Sugimoto, Makoto Takahashi, Yutaka Kojima, Michitoshi Goto, Yuichi Tomiki, Kazuhiro Sakamoto
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Rahul P. Bhamkar, Roopali V. Telang, Paresh Jain, Subodh Gupta
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A Rare Type of Primary Internal Hernia Causing Small Intestinal Obstruction
Sibabrata Kar, Vandana Mohapatra, Pratap Kumar Rath
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RETROCECAL HERNIA: A RARE CAUSE OF SMALL BOWEL OBSTRUCTION
Lal Mani Singh, Vinod Yedalwar
Journal of Evolution of Medical and Dental Sciences.2014; 3(20): 5509. CrossRef
Right salpingo-ovarian and distal ileal entrapment within a paracaecal hernia presenting as acute appendicits
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Rare peritoneal bands and recesses: incidental findings in a cadaveric dissection
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A case report of lateral paracecal hernia
Masako SUYAMA, Masamichi YASUNO, Hidenori TAKAHASHI, Tatsuro WAKAYAMA
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Internal Herniation Due to Appendix Vermiformis Rotation: A Rare Case of an Acute Abdomen
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Original Article

Predictive Factor for Surgical Indication in Postoperative Adhesive Small Bowel Obstruction.: Kang, Ji Woong , Nam, Jung Kwang , Kim, Byung Seok , Moon, Duk Jin; J Korean Soc Coloproctol. 2010;26(3):186-189.; DOI: https://doi.org/10.3393/jksc.2010.26.3.186

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Abstract PDF: PURPOSE
There is a long-standing debate about whether postoperative adhesive small bowel obstruction (SBO) is best managed operatively or nonoperatively. The aim of this study is to define predictive factors for surgical indication in the treatment of an adhesive SBO.
METHODS
Medical records and laboratory data of 211 patients who had a SBO after a laparotomy from January 2000 to December 2008 were reviewed retrospectively. The patients were divided into two groups according to the modality of SBO treatment: operatively and nonoperatively. The laboratory data and clinical parameters were compared between the two groups and a statistical analysis was performed.
RESULTS
A Mann-Whitney analysis revealed previous SBO history, amylase, erythrocyte sedimentation rate (ESR), creatine phosphokinase, drainage amount via a Levin tube to be significant factors associated with surgical management. A multivariate analysis showed drainage amount via a Levin tube of 500 mL/day or greater (P=0.007), amylase of 90 IU/L or greater (P=0.04), and ESR of 11 mm/hr or greater (P=0.03) to be independent predictive factors for surgery.
CONCLUSION
Surgical management should be considered among adhesive SBO patients with elevated amylase (> or =90 IU/L) and ESR (> or =11 mm/hr) and with large drainage amount through the Levin tube (> or =500 mL/day).

Case Report

Intestinal Obstruction Aggravated by Colonoscopy: A Case Report.: Kim, Hae Jung , Lee, In Tak , Yok, Eu Gon , Lee, So Jin , Lee, Suk Hee , Kim, Do Sun , Lee, Du Han; J Korean Soc Coloproctol. 2009;25(1):56-58.; DOI: https://doi.org/10.3393/jksc.2009.25.1.56

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Abstract PDF

Colonoscopy is a frequently performed procedure used for colorectal cancer screening. Most frequent complication is colonic perforation and bleeding. Other visceral injuries are very rare, but injuries to the spleen and liver have been described. We report on 66-yr-old female who presented with abdominal pain after uneventful colonoscopy. Abdominal CT scan revealed a band at previous hysterectomy site and dilated small bowel suggesting strangulated loop. A broad based knowledge of the different complication is necessary to decrease the risk of associated morbidity and mortality.

Citations

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Severe ileus after colonoscopy in a patient on peritoneal dialysis
Sang Un Kim, Su Hee Kim, So Yoon Hwang, Ryang Hi Kim, Ji Young Choi, Jang Hee Cho, Chan Duck Kim, Yong Lim Kim, Sun Hee Park
Yeungnam University Journal of Medicine.2017; 34(1): 119. CrossRef

Original Article

Small Bowel Obstruction in Patients without a Previous History of Abdominal Operation.: Chung, Il Yong , Moon, Sang Hui , Park, Hyung Chul , Park, Kyu Joo; J Korean Soc Coloproctol. 2007;23(1):16-21.; DOI: https://doi.org/10.3393/jksc.2007.23.1.16

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Abstract PDF: PURPOSE
Intra-abdominal adhesion related to prior abdominal surgery is the most common cause of small bowel obstruction (SBO). However, there are subsets of patients with SBO without a history of previous operation. We studied the characteristics of these patients.
METHODS
The medical records of 311 patients underwent operations at Seoul National University Hospital between Jan. 1994 and Oct. 2005 were reviewed. A retrospective analysis of the incidence, etiology, diagnostic method, preoperative hospital stay, operative findings and methods, complication rates, postoperative hospital stay, re-admission rate, and reoperation rate of SBO was performed, and the results were compared with those of patients with a history of previous operation.
RESULTS
Among the 311 patients (54.4 +/- 14.7 yr, M:F=1.5:1), 48 patients (15.3%) had no history of operation. The etiologies of SBO without a history of operation were malignancy (23.0%), bezoar (14.5%), adhesion (10.4%), Crohn's disease (10.4%), tuberculosis (8.3%), and appendicitis (8.3%). SBO without prior abdominal surgery showed a longer preoperative hospital stay, which was not statistically significant. The accuracies of CT and small bowel series among patients without a history of operation were 68.4% and 54.5%, respectively. SBO without prior abdominal surgery showed a lower complication rate (8.3% vs. 26.6%, P=0.006) and shorter postoperative hospital stays (12.7 +/- 6.9 days vs. 16.1 +/- 10.4 days, P=0.032).
CONCLUSIONS
Among the patients who underwent an operation for SBO, 15.3% had no history of previous operation. The most common cause of SBO without a history of operation was malignancy. SBO without a history of operation showed a lower complication rate and a shorter postoperative hospital stay compared with SBO with a history of operation.

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