Challenges in diagnosing adhesive small bowel obstruction

查看全文 作　　者：Thijs R van [1]Oudheusden;Bart AC [2]Aerts;Ignace HJT de [1]Hingh;Misha DP [1]Luyer

机构地区：[1]Department of Surgery,Catharina Hospital,5623 EJ,Eindhoven,The Netherlands;[2]Department of Surgery,Amphia Hospital,4818 CK,Breda,The Netherlands

出　　处：《World Journal of Gastroenterology》索引2013年第19卷第43期,共5页

摘　　要：Adhesive small bowel obstruction(ASBO)is the most frequently encountered surgical disorder of the small intestine.Up to 80%of ASBO cases resolve spontaneously and do not require invasive treatment.It is important to identify such patients that will benefit from conservative treatment in order to prevent unnecessarily exposing them to the risks associated with surgical intervention,such as morbidity and further adhesion formation.For the remaining ASBO patients,timely surgical intervention is necessary to prevent small bowel strangulation,which may cause intestinal ischemia and bowel necrosis.While early identification of these patients is key to decreasing ASBO-related morbidity and mortality,the non-specific signs and laboratory findings upon clinic presentation limit timely diagnosis and implementation of appropriate clinical management.Combining the clinical presentation findings with those from other diagnostic imaging modalities,such as abdominal X-ray,computed tomography-scan and water-soluble contrast studies,will improve diagnosis of ASBO and help clinicians to better evaluate the potential of conservative management as a safe strategy for a particular patient.Nonetheless,patients who present with moderate findings by all these approaches continue to represent a challenge.A new diagnostic strategy is urgently needed to further improve our ability to identify early signs of strangulated bowel,and this diagnostic modality should be able to indicate when surgical management is required.A number of potential serum markers have been proposed for this purpose,including intestinal fatty acid binding protein andα-glutathione S transferase.On-going research is attempting to clearly define their diagnostic utility and to optimize their potential role in determining which patients should be managed surgically. 关键词：Adhesive small BOWEL OBSTRUCTION Diagnosis Clinical management Biological MARKERS Intestinal FATTY acid binding protein α-glutathione S TRANSFERASE

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Challenges in diagnosing adhesive small bowel obstruction

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