Objective We sought a good understanding of the current role of computed tomography (CT) in the diagnosis of small bowel obstruction (SBO).Methods We looked for the best evidence on computed tomography for diagnosing small bowel obstruction by searching MEDLINE/PubMed (1978-April, 2006), SUMsearch (1978-April, 2006), CNKI (1978-April, 2006) and critically appraised the evidence. Results There was powerful evidence supporting the efficacy of computed tomography in the diagnosis of small bowel obstruction. Given the current evidence together with our clinical experience and considering the patient and his family members, values and preferences, computed tomography was done. We confirmed the diagnosis of strangulating small bowel obstruction, which needed immediate operation. Conclusions Computed tomography is a very useful tool for the diagnosis of small bowel obstruction with high sensibility and specificity.
Objective To explore the bacterial translocation of mesenteric lymph nodes （MLNs） of the ileum and the spectrum of bacteria in patients with small bowel obstruction.Methods Total 84 patients were divided into study group （with small bowel obstruction） and control group （without small bowel obstruction）. MLNs were obtained under sterile conditions intraoperatively， and which were processed for culture of aerobic and anaerobic organisms. The rate of bacterial translocation and postoperative infection were compared between two groups and the species of bacterial translocation was identified. Results The bacterial translocation rate in the study group was higher than that in the control group 〔57.1% （24/42） versus 16.7% （7/42），χ2=14.775， P＜0.01〕. Escherichia coil was the most commonly bacteria （20）. Emergency surgery and age over 70 years were associated with bacterial translocation （P＜0.05）. Postoperative infection complications rate in the bacterial translocation patients was higher than that in the patients without bacterial translocation 〔29.0% （9/31） versus 3.8% （2/53），χ2=10.965，P＜0.05〕. Conclusions Bacterial translocation to MLNs occurres more frequently in patients with small bowel obstruction，non-elective surgery， and elderly.
ObjectiveTo study the application value of mixed formulations consisting of paraffin oil, dimethyl silicone oil, and senna preparations in treatment for incomplete adhesive intestinal obstruction after laparotomy. MethodsOne hundred and twentyeight patients diagnosed incomplete adhesive intestinal obstruction admitted to this hospital from March 2005 to May 2008 were randomly divided into trial group and control group. For the control group, the tradition therapy including fasting, gastrointestinal decompression, fluid replacement therapy, and enema with soap and water were used for treatment. For the trial group, the mixed formulations consisting of paraffin oil, dimethyl silicone oil, and senna preparations were injected into stomach by the nasogastric tube on the basis of traditional treatment used for the control group. Some indicators including the successful rate of nonoperative treatment, the time that obstructive symptoms resolved and returned to normal exhaust and defecation and normal diet, and recurrence rate were compared between two groups. ResultsThe successful rate of nonoperative treatmentin in the trial group were significantly higher than that in the control group 〔92.1% (70/76) versus 69.2% (36/52), Plt;0.01〕. The average time that recovered to normal exhaust and defecation in the trial group and the control group was 32.5 d and 47.8 d, respectively. The average time that recovered to normal diet in the trial group and the control group was 3.2 d and 5.3 d, respectively. The time that recovered to normal exhaust and defecation, and diet in the trial group were significantly shorter than those in the control group (Plt;0.01). The recurrence rate had no significant difference between two groups (Pgt;0.05). ConclusionThe mixed formulations consisting of paraffin oil, dimethyl silicone oil, and senna preparations improve recovery of intestinal function and reduce surgical intervention rate.