Acute postoperative perforated ulcers of the small bowel as a topical problem of modern surgery
https://doi.org/10.24884/0042-4625-2019-178-2-33-37
Abstract
The objective is to study acute perforated ulcers of the small bowel, which arise as a complication after operations on the abdominal and pelvic organs.
Material and methods. A retrospective analysis of patient’s cases whose postoperative period was complicated by the development of acute perforated ulcers of small bowel.
Results. Over the past 20 years, the frequency of this complication increased by 8 times. In the structure of primary nosology, various types of oncological diseases prevail (69.4 %), moreover most patients underwent emergency operations. Most often, this complication occurred on the 4–10th day of the postoperative period, and the ulcers were multiple. Among these patients, there was an extremely high mortality rate of 74.2 %.
Conclusion. Considering the significant increase in the number of this complication in recent years and the high level of mortality among patients, a detailed study of acute perforated ulcers of the small intestine of the postoperative period is necessary.
About the Authors
V. P. ZemlyanoyRussian Federation
Viacheslav P. Zemlyanoy.
47 Piskarevskii street, St. Petersburg, Russia, 195067.
A. B. Singaevskiy
Russian Federation
Andrei B. Singaevskiy.
47 Piskarevskii street, St. Petersburg, Russia, 195067.
D. V. Gladyshev
Russian Federation
Dmitrii V. Gladyshev.
St. Petersburg.
N. M. Vryblevskiy
Nikolai M. Vryblevskiy.
St. Petersburg.
E. M. Nesvit
Evgeniya M. Nesvit.
Corresponding author: Evgeniya M. Nesvit, North-Western State Medical University named after I. I. Mechnikov, 47 Piskarevskii street, St. Petersburg, Russia, 195067.
M. A. Efendieva
Marina A. Efendieva.
47 Piskarevskii street, St. Petersburg, Russia, 195067.
References
1. Weiser T. G., Regenbogen S. E., Thompson K. D. An estimation of the global volume of surgery : a modelling strategy based on available data // The Lancet. 2008. Vol. 372. P. 139–144.
2. Adar R., Bass A. Iatrogenic complications in surgery // Annals of Surgery. 1982. Vol. 196. P. 725–729.
3. Pearse R. M., Moreno R. P., Bauer P. et al. Mortality after surgery in Europe : a 7 day cohort study // The Lancet. 2012. Vol. 380. P. 1059–1065.
4. Земляной В. П., Нахумов М. М., Летина Ю. В. Особенности течения перфораций полых органов брюшной полости у инфекционных больных // Вестн. Северо-Запад. гос. ун-та им. И. И. Мечникова. 2018. Т. 10, № 1. С. 27–32. [Zemlyanoi V. P., Nakhumov M. M., Letina Yu. V. Osobennosti techeniya perforatsii polykh organov bryushnoi polosti u infektsionnykh bol’nykh. Vestnik Severo-Zapadnogo gosudarstvennogo universiteta im. I. I. Mechnikova. 2018;10(1):27– 32. (In Russ.)].
5. Bang S., Park Y. B., Kang B. S. et al. CMV enteritis causing ileal perforation in underlying lupus enteritis // Clinical Rheumatology. 2004. Vol. 23. P. 69–72.
6. Seabra J., Coelho H., Barros H. et al. Acute tuberculous perforation of the small bowel during antituberculosis therapy // Journal of Clinical Gastroenterology. 1993. Vol. 16. P. 320–322.
7. Sutton C. D., White S. A., Marshall L. J. et al. Idiopathic chronic ulcerative enteritis – the role of radical surgical resection // Digestive Surgery. 2002. Vol. 19. P. 406–408.
8. Ghosh S. C., Nolan G. J., Simpson R. R. A concealed small bowel perforation in an adult secondary to bicycle handlebar trauma // Annals of The Royal College of Surgeons of England. 2013. Vol. 95. P. 69–70.
9. Rajagopalan A. E., Pickleman J. Free perforation of the small intestine // Annals of Surgery. 1982. Vol. 196. P. 576–579.
10. Arnheim E. E. Regional enteritis with perforation, abscess and peritonitis // Journal of Mount Sinai Hospital. 1935. Vol. 2. P. 61–66.
11. Ikeuchi H., Yamamura T. J. Free perforation in Crohn’s disease : review of the Japanese literature // Journal of Gastroenterology. 2002. Vol. 37. P. 1020–1027.
12. Zeino Z., Sisson G., Bjarnason I. Adverse effects of drugs on small intestine and colon // Best Practice & Research : Clinical Gastroenterology. 2010. Vol. 24. P. 133–141.
13. Lecarpentier E., Ouaffi L., Mir O. et al. Bevacizumabinduced small bowel perforation in a patient with breast cancer without intraabdominal metastases // Investigational New Drugs. 2011. Vol. 29. P. 1500–1503.
14. Волков B. E., Волков С. В. Эрозивно-язвенные поражения желудочно-кишечного тракта в раннем послеоперационном периоде // Вестн. Чуваш. ун-та им. И. Н. Ульянова. 2005. № 2. С. 50–56. [Volkov B. E., Volkov S. V. Erozivno-yazvennye porazheniya zheludochno-kishechnogo trakta v rannem posleoperatsionnom periode. Vestnik Chuvashskogo universiteta imeni I. N. Ul’yanova. 2005;(2):50–56. (In Russ.)].
15. Гольбрайх В. А., Маскин С. С., Бобырин А. В. и др. Острые перфоративные язвы тонкой кишки у больных с распространенным гнойным перитонитом // Bulletin of Experimental and Clinical Surgery. 2012. Vol. 5. P. 51–53. [Gol’braikh V. A., Maskin S. S., Bobyrin A. V. i dr. Ostrye perforativnye yazvy tonkoi kishki u bol’nykh s rasprostranennym gnoinym peritonitom. Bulletin of Experimental and Clinical Surgery. 2012;5:51–53. (In Russ.)].
Review
For citations:
Zemlyanoy V.P., Singaevskiy A.B., Gladyshev D.V., Vryblevskiy N.M., Nesvit E.M., Efendieva M.A. Acute postoperative perforated ulcers of the small bowel as a topical problem of modern surgery. Grekov's Bulletin of Surgery. 2019;178(2):33-37. (In Russ.) https://doi.org/10.24884/0042-4625-2019-178-2-33-37