16:26,14,Feb,2009 | (1065/0/0) | Original

functional bowel obstruction


Zhang Zhijun Yin Xueming 1 2
(1 Yunmeng County, Hubei Province, Yee Tong Center Hospital 432500; 2 Yunmeng County, Hubei Province Chinese Medicine Hospital General Surgery 432 500)
【Key Words】 R574.2 Document code】 【A】 【Article ID 1672-5085 (2010) 23-0333-01
Abstract Objective To investigate the function of intestinal obstruction in the treatment of the elderly. Methods Retrospective analysis of cases. Results of Integrative Medicine is effective elderly functional intestinal obstruction. Conclusion The correct choice of appropriate treatment can reduce patient pain and some serious complications.
Key words elderly functional intestinal obstruction
Functional bowel dysfunction due to obstruction to the normal intestinal contents can not pass delivery [1]. Intestinal obstruction in the elderly, intestinal disorders, food obstruction more common, the danger is also large. Elderly due to degenerative changes in body organs, bowel dysfunction, intestinal digestion, absorption, secretion, and so prone to good or poor motility disorders. Average adult to digest the food, the gastrointestinal tract in the elderly may not be easily digested. These clumps are not fully digested the smooth discharge of adults, the elderly may not discharge, thus blocking the intestine, causing intestinal obstruction. The elderly to reduce intestinal secretion of digestive juice, combined with weak peristalsis, often habitual constipation, food scraps into a secret knot of fecal accumulation may also cause intestinal obstruction. In addition, the elderly, such as with other diseases, so that the secretion of gastrointestinal motility further reduced, but also the factors that induce food obstruction [2].
The formation of senile functional intestinal obstruction, the clinical treatment more difficult, but also may bring some new surgical complications, such as most elderly patients have adhesions, leading to intestinal obstruction, patients will face the risk of reoperation.
Our hospital since 2003, with East-meets-treated 15 elderly patients with functional intestinal obstruction, and achieved good results.
1 Materials and Methods
1.1 General Information
15 patients 9 were male and 6 female, aged 62 to 83 years old, had no history of abdominal surgery, of which 11 cases of incomplete intestinal obstruction, complete obstruction in 4 cases. The main clinical manifestations varying degrees of abdominal pain, abdominal distension, anal stop the exhaust and defecation, nausea, and vomiting. All patients had no history of abdominal surgery. Multi-slice CT examination without mechanical obstruction.
1.2 before treatment of non-surgical treatment, routine gastrointestinal decompression, antibiotics, rehydration. Appropriate to the SS. Observation of vital signs and abdominal symptoms. Medicine into the tube, in the treatment of intestinal obstruction while taking into account the treatment of intest
inal obstruction, to rid of high blood pressure, chronic bronchitis, pulmonary heart disease, diabetes and so on. Many small low-pressure enema.
Journal articles classified information, all in library journals as the group 3 cases of constipation, laxatives such as senna clothes cause intestinal disorders, therefore, we do not advocate the use of laxatives to treat.
1.3 The outcome of 3 patients, and other non-surgical treatment by decompression, the bloating continues, there peritoneal irritation. Surgical treatment, in addition to case patients died of postoperative complications, and the remaining patients after such treatment, intestinal obstruction symptoms, were cured. The average length of stay 9.4 days.
2 typical cases
2.1 xx, male, 70 years old, abdominal pain for three days, stop the exhaust anal defecation day. Admission examination: T36.7 bp120/85 skin stained yellow sclera (-), no abnormal heart and lung, abdominal and intestinal uplift Chuanghen no surgery, no tenderness and rebound tenderness. Hyperthyroidism bowel sounds, sparkling over the water sound. All without a history of previous attacks. Laboratory examinations: blood-wbc11.0 n81%, abdominal plain film abdominal see two 5 * 7 2 * 4cm fluid level. B renal ultrasound showed no abnormal liver and gallbladder. Line fasting, gastrointestinal decompression, fluid anti-infective treatment. Solution loose stools a hospital that night. Chinese herbal medicine into the tube the next day (Da Cheng Qi Decoction) line width of intestinal gas, diarrhea Results line lag. The fifth day the symptoms disappeared, normal bowel movements. Abdominal plain film review on the eighth day without fluid level, colonoscopy (-). Cured.
2.2 M, 82 years old. Because of abdominal pain, bloating, nausea, vomiting, defecation 5 days without exhaust treatment, physical examination: T37.4 'c p91 R20 Bp130/90 Shen Qing, jaundice (-), cardiopulmonary auscultation (-), abdominal distension, abdominal tenderness and rebound tenderness (), weak bowel sounds, liver, spleen and kidney (-). Secondary inspection: wbc17.6 PD said flatulence, ur (-), B super-normal. History of constipation for many years. The anti-infection treatment after admission was no improvement in abdominal pain, laparotomy, intraoperative see the jejunum with a 5 * 6cm blockage intestine, colon no abnormality was found, the line the intestinal wall incision, removal of foreign body. Nutritional support after anti-infection symptoms were not relieved, not exhaust defecation, bloating pain intensified, with renal failure, the 15th day after death.
3 Discussion
Functional intestinal obstruction in the elderly a special type of intestinal obstruction, there may be multiple complaints and signs of small, non-surgical treatment should be selected, due to surgery will increase the adhesion of new opportunities, and enable greater adhesion area, thereby increasing the re-adhesion intestinal fistula, intra-abdominal complications such as the chance of infection [3].
Functional obstruction, medicine called intestinal paralysis, intestinal paralysis in the name of the "Canon." "Q
functional bowel obstruction

Current location: China paper Download Center> Medicine> Clinical> text elderly treatment of functional intestinal obstruction
Source: China paper Download Center [10-09-24 16:01:00] Author: Yin Xueming Zhang Zhijun Editor: studa090420 Abstract Objective To investigate the function of intestinal obstruction in the treatment of the elderly. Methods Retrospective analysis of cases. Results of Integrative Medicine is effective elderly functional intestinal obstruction. Conclusion The correct choice of appropriate treatment can reduce patient pain and some serious complications.
Key words elderly functional intestinal obstruction
Functional bowel dysfunction due to obstruction to the normal intestinal contents can not pass delivery [1]. Intestinal obstruction in the elderly, intestinal disorders, food obstruction more common, the danger is also large. Elderly due to degenerative changes in body organs, bowel dysfunction, intestinal digestion, absorption, secretion, and so prone to good or poor motility disorders. Average adult to digest the food, the gastrointestinal tract in the elderly may not be easily digested. These clumps are not fully digested the smooth discharge of adults, the elderly may not discharge, thus blocking the intestine, causing intestinal obstruction. The elderly to reduce intestinal secretion of digestive juice, combined with weak peristalsis, often habitual constipation, food scraps into a secret knot of fecal accumulation may also cause intestinal obstruction. In addition, the elderly, such as with other diseases, so that the secretion of gastrointestinal motility further reduced, but also the factors that induce food obstruction [2].
The formation of senile functional intestinal obstruction, the clinical treatment more difficult, but also may bring some new surgical complications, such as most elderly patients have adhesions, leading to intestinal obstruction, patients will face the risk of reoperation.
Our hospital since 2003, with East-meets-treated 15 elderly patients with functional intestinal obstruction, and achieved good results.
1 Materials and Methods
1.1 General Information
15 patients 9 were male and 6 female, aged 62 to 83 years old, had no history of abdominal surgery, of which 11 cases of incomplete intestinal obstruction, complete obstruction in 4 cases. The main clinical manifestations varying degrees of abdominal pain, abdominal distension, anal stop the exhaust and defecation, nausea, and vomiting. All patients had no history of abdominal surgery. Multi-slice CT examination without mechanical obstruction.
1.2 before treatment of non-surgical treatment, routine gastrointestinal decompression, antibiotics, rehydration. Appropriate to the SS. Observation of vital signs and abdominal symptoms. Medicine into the tube, in the treatment of intestinal obstruction while taking into account the treatment of intestinal obstruction, to rid of high blood pressure, chronic bronchitis, pulmonary heart disease, diabetes and so on. Many small low-pressure enema.
3 cases in this group because of constipation, laxatives such as senna clothes cause intestinal disorders, therefore, we do not advocate the use of laxatives to treat.
1.3 The outcome of 3 patients, and other non-surgical treatment by decompression, the bloating continues, there peritoneal irritation. Surgical treatment, in addition to case patients died of postoperative complications, and the remaining patients after such treatment, intestinal obstruction symptoms, were cured. The average length of stay 9.4 days. Links in the paper for download http://www.studa.net
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Intestinal paralysis in the name of the "Canon." "Su asked paralysis on the chapter": "intestinal paralysis who drink out of a few may not, in the fight asthma, made supper time to vent."
Intestinal paralysis and more from the abdominal surgery, or because of bowel, abdominal lesions, or systemic disorders, paralysis and other effects, so that the body of intestinal paralysis, caused by air-barrier. Abdominal distention, such as drums, abdominal pain, vomiting, constipation, no bowel, gas as the main vector of visceral performance of paralysis illness disease.
The disease mostly said that Western medicine paralytic, functional bowel obstruction.
[Diagnosis is based on]
1. Mostly occurs in abdominal surgery, injury, paralysis, peritonitis, retroperitoneal hematoma, renal abscess and infection, toxic shock and other severe diseases, hypokalemia case.
2. There is expansion, closed, pain, vomiting four patients; bloating significantly, generally without abdominal pain, but later severe abdominal swelling can be caused due to persistent pain and dull pain, frequent vomiting, stomach contents may only be the future for the intestinal contents, anal to stop a bowel movement and discharge, or feel abdominal channeling of gas to go, air resistance is Tong Shen, bowel gas channeling the pain reduction, often accompanied by palpitations, fever embolism.
3. Physical examination may have bulging abdomen, such as the beating of drums, weakening or disappearance of bowel sounds, thick and greasy tongue coating and more.
Abdominal fluoroscopy 4.X Line: See the small intestine and colon were tested uniform expansion, but the product of intestinal gas and liquid within the less.
If peritonitis caused by a person, exudative fluid within the abdominal cavity, bowel floating in which intestinal widened spacing, edge blur, jejunal mucosal fold thickening.
[Differential Diagnosis]
1. Bowel Results: paroxysmal abdominal pain cramps, bloating more times, bowel sounds hyperthyroidism, was high profile, visible and audible intestinal gas through the water sound. X ray abdomen perspective see flatulence and gas above the liquid surface is limited bowel obstruction, adhesions oppressed, sometimes visible, "coffee" sign. Collecting Medical Education Network
2. Gas pain: paroxysmal abdominal pain processes, may, by rule or natural remission, remission no obvious symptoms, abdominal hi by the general, no mass, no anus to stop defecation, discharge phenomena, X ray and gastrointestinal examination found no organic disease.
[TDS]
1. Bowel Qi stagnation: bloating, such as drums, abdominal pain, be
lching, nausea, vomiting, constipation, no vector gas, red tongue, yellow coating, pulse string. Line width of intestinal gas, diarrhea Results line lag.
2. Cold in the gastrointestinal Card: abdominal distension and pain, nausea, vomiting, constipation, aversion to cold, looking Gong white, white coating, pulse string strong. Warm in the cold, diarrhea Results line lag.
3. Stasis gastrointestinal Card: abdominal distension and pain or tingling, pain. Fixed, constipation, dark purple tongue or ecchymosis, pulse string astringent. Take stasis.
4. Spleen Qi Stagnation: abdominal distention abdominal fullness, belching, vomiting, loss of appetite, Shenpi fatigue, yellow face minimalist, constipation, pale tongue, white coating, slow pulse string. Spleen Qi, diarrhea Results line lag.
5. Phlegm in the retention syndrome: abdominal pain, fullness, vomiting, water liquid, bowel Luk Luk, dry mouth, constipation, greasy or slippery moss, pulse, or V chord. Attack by water to drink.
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