MORPHOLOGICAL CHANGES OF THE SMALL INTESTINE IN ACUTE STRANGULATIVE INTESTINAL OBSTRUCTION IN THE STAGE OF DECOMPOSITION IN CHILDREN

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Abstract

Purpose. The purpose was to determine the depth and prevalence of pathomorphological changes in the small intestine of children at the distance from the visible border of necrosis with decompensated acute strangulated intestinal obstruction (ASIO) to determine the minimum possible length of intestinal resection.

Material and methods. Morphological studies of a resected fragment of the small intestine were performed in 24 children aged 3 days to 18 years who had undergone a surgery for ASIO with intestinal necrosis. Strangulated adhesive obstruction was found in 17 children, five children had congenital intestine torsion and two children faced small intestinal strangulation in the congenital mesenteric defect. The postsurgical material was studied morphologically using histological stains with the distance of 3 cm between the section.

Results. The depth, prevalence of the morphological changes in the small intestinal wall, intensity and length of morphological changes in children with decompensated ASIO were determined.

Conclusion. A differentiated approach to the selection of resection scope in the proximal and distal directions from the visible border of ASIO-related necrosis is necessary. The distances are twice shorter in children as compared to adults. Refusal from extensive resections will enable to reduce the rate of short bowel syndrome in children.

About the authors

A. E. Solovev

Ryazan State Medical University named after academician I. P. Pavlov

Email: fake@neicon.ru

Anatolij E. SOLOVYEV - Dr. Sci. (Med.), professor, head of the Department of Pediatric Surgery

9, High-voltage street, Ryazan, 390026

Россия

I. V. Vasin

Ryazan State Medical University named after academician I. P. Pavlov

Email: fake@neicon.ru

Igor V. VASIN - Cand. Sci. (Med.), Head of the Pathological and Anatomical Department of the OKB, Associate Professor of the Department of Histology

9, High-voltage street, Ryazan, 390026

Россия

O. А. Kul’chitskij

Ryazan State Medical University named after academician I. P. Pavlov

Author for correspondence.
Email: beerzombie@rambler.ru

Oleg A. KULCHITSKIJ - Assistant of the Department of Pediatric Surgery

9, High-voltage street, Ryazan, 390026

Россия

References

  1. Пугаев А. В., Ачкасов Е. Е., Негребов М. Г. Морфологические изменения тонкой кишки при острой странгуляционной тонкокишечной механической непроходимости.// Клиническая медицина. – 2015. -Т.93. – № 4 – с.56–61.
  2. Chang Y. J., Yan D. C., Lai J. Y., Chao H. C., Chen C. L., Chen S. Y. et al. Strangulated small bowel obstruction in children.//J Pediatr Surg. 2017; 52 (8):1313–7. doi: 10.1016/j.jpedsurg.2017.03.002.
  3. Разумовский А. Ю., Дронов А. Ф. Детская хирургия. Национальное руководство.// М.: ГЭОТАР-Медиа, – 2016. – с. 940
  4. Bologna Guidelines for Diagnosis and Management of Adhesive Small Bowel Obstruction (ASBO): 2010 EvidenceBased Guidelines of the World Society of Emergency Surgery. //World J. Emerg. Surg. 2011; 6:
  5. Published online 2011 January 21. doi: 10.1186/1749‑7922‑6‑5PMCID: PMC3037327 5. Marincek B. Nontraumatic abdominal emergencies: acute abdominal pain: diagnostic strategies.// Eur. Radiol. 2002; 12 (9): 2136–50. doi: 10.1007/s00330‑002‑1569‑x.
  6. Rodriguez Zorro A., Vivas Diaz J. H. Death caused by appendicular knotting and small-bowel strangulation in a child: A case report and review. //Med Sci Law. 2018; 58 (2):115–118. doi: 10.1177/0025802418756780.
  7. Качина Ю. А. Интраоперационные ошибки определения жизнеспособности тонкой кишки при выполнении ее резекции в связи с острой кишечной непроходимостью.// Военно-медицинский журнал. – 2010. – Т.331. – № 12. – с. 46.
  8. Sykes J. A., Norton K. I., Bhattacharya N., Stombaugh L. Small bowel obstruction secondary to strangulation through a defect in the falciform ligament after blunt abdominal trauma in a pediatric patient.// Pediatr Emerg Care. 2010; 26 (6):436–8. doi: 10.1097/PEC.0b013e3181e15e7d.
  9. Feigin E., Kravarusic D., Goldrat I., Steinberg R., Dlugy E., Baazov A. The 16 golden hours for conservative treatment in children with postoperative small bowel obstruction. //J Pediatr Surg. 2010;45 (5):966–8. doi: 10.1016/j.jpedsurg.2010.02.025.
  10. Милюков В. Е. Динамика морфологических изменений стенок тонкой кишки после устранения острой тонкокишечной непроходимости в эксперименте. Вестник новых медицинских технологий. – 2001. – Т.8, – № 2. – с. 48–51.
  11. Lee C. Y., Hung M. H., Lin L. H., Chen D. F. Evaluation of a water-soluble contrast agent for the conservative management of adhesive small bowel obstruction in pediatric patients. //J Pediatr Surg. 2015; 50 (4):581–5. doi: 10.1016/j.jpedsurg.2014.11.034.
  12. Ouédraogo I., Wandaogo A., Bandré É., Balima É., Ouédraogo F., Tapsoba W. T. Acute intestinal obstruction. //Med Sante Trop. 2013 Jul-Sep;23 (3):267–8. doi: 10.1684/mst.2013.0221.
  13. Негребов М. Г., Ачкасов Е. Е., Александров Л. В., Ба М. Р. Эволюция подходов к классификационным критериям острой кишечной непроходимости. // Хирургическая практика. – 2013. – 1. с.24–9.
  14. Сапин М. Р., Милюков В. Е., Антипов Е. Ю. Патогенетическое обоснование лечебной тактики при острой странгуляционной тонкокишечной непроходимости. //Вестник хирургической гастроэнтерологии. – 2008. – 1. – 42–51.

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Copyright (c) 2018 Solovev A.E., Vasin I.V., Kul’chitskij O.А.

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