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[MORPHOLOGICAL CHANGES IN THE SMALL INTESTINE ASSOCIATED WITH STRANGULATION OF MECHANICALLY OBSTRUCTED BOWEL]

A V Pugaev, E E Achkasov, M G Negrebov

    Klinicheskaia Meditsina
    |July 10, 2015
    PubMed
    Abstract

    Insights

    Resection extent for small intestine obstruction should be individualized based on obstruction severity. Avoiding extensive resection, particularly proximally, can prevent short bowel syndrome and malabsorption.

    Area of Science:

    • Gastroenterology
    • Surgical Pathology
    • Morphology

    Context:

    • Acute mechanical small bowel obstruction necessitates surgical intervention, often involving bowel resection.
    • Pathomorphological changes in the small intestine vary with obstruction severity and decompensation.
    • Determining the optimal resection margin is crucial to prevent postoperative complications.

    Purpose:

    • To evaluate the extent and prevalence of pathomorphological changes in the small intestine at varying distances from necrotic tissue.
    • To correlate these changes with the degree of acute mechanical obstruction.
    • To inform the selection of optimal resection margins in cases of obstructed necrotic bowel.

    Summary:

    • Histological analysis of small intestine fragments from 52 patients revealed that pathomorphological changes correlated with obstruction severity and decompensation.
    • Changes increased with greater obstruction severity.
    • Resection margins should be individualized based on obstruction compensation.

    Impact:

    • Individualized resection strategies, avoiding extensive resection proximally, can reduce the incidence of short bowel syndrome and malabsorption.
    • This approach optimizes patient outcomes following surgery for mechanical small bowel obstruction.

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