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@#Abdominal distention after cardiopulmonary resuscitation (CPR) is a common phenomenon that presents in the emergency department. It is caused by a long period of bag-valve mask ventilation or esophageal intubation. However, a rare but life-threating diagnosis should be considered when distention progresses rapidly. Here, we reported a patient who developed a fever and abdominal pain that couldn’t be relieved by gastric decompression.
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Objective: To observe the efficacy of umbilical moist-heat application of modified Da Chengqitang in treating ventosity after noninvasive ventilation, and the regulatory effect on level of gastrointestinal motility hormone. Method: One hundred and sixty patients were randomly divided into control group and observation group by random number table. Patients in control group got mosapride citrate tablets, 5 mg/time, 3 times/days. In addition tothe therapy in control group, patients in observation group was also given mbilical moist-heat application of modified Da Chengqitang, 30 min/time, 2 times/day. And a course of treatment was 7 days. Before and after treatment, degree of abdominal distention was measured by a tape and subjective evaluation. Time of recovery of bowel sounds, remission of abdominal distention, exhausting and defecation, and the total time of using respirator, pressure of using respirator, and the total days of using respirator were recorded. And levels of gastrin (GAS), motilin (MTL), vasoactive intestinal peptide (VIP) and somatostatin (SS) were detected. Result: According to the rank sum test, the clinical effect in observation group was superior to that in control group (Z=2.484, PZ=2.456, PPPPP2, PaCO2, GAS, MTL were higher than those in control group, whereas PaCO2, VIP and SS were lower than those in control group (PPConclusion: Umbilical moist-heat application of modified Da Chengqitang can relieve abdominal distention and dyspnea, reduce intraperitoneal pressure, improve the recovery of gastrointestinal function, and regulate gastrointestinal hormone level.
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Children abdominal distention or bloating is one of the most common gut symptoms.It can be caused not only by gastroenterological diseases,but also by the illnesses beyond the gut.We discussed children abdominal distention here about causes,diagnostic clues,differential diagnosis,and treatment recommendations.All clinicians should carefully evaluate and cautiously treat abdominal distention.
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Objective To observe the effect of strict designed form for chewing gum on the first anus exhaust and defecation after laparoscopic surgery,and the actual compliance of chewing gum was investigate.Methods Totally 106 patients with abdominal operation in gynaecology department of Shaanxi Provincial People's Hospital from August to December 2016 were classified into chewing gum group and control group according to stratified random sampling.Chewing gum group had 53 cases,and the principle and requirement of chewing gum in patients and relatives were explained before operation.The xylitol chewing gum was chosed and chewed 2 to 3 gums in the 2 hours after operation,chewed about 30 times every minute and last for 15 to 20 minutes each time.From 7∶00 to 22∶00 the interval was 2 hours, and the interval at the rest time must not exceed 3 hours until exhaust.Fifty-three cases in control group received routine nursing,and started to drink a small amount of water 6 hours after operation,and gradually started to eat.Other dietary guidance and medical care measures were identical in both groups.Compared the first anus exhaust time,defecation time,abdominal distension and postoperative hospitalization time in two groups,and the actual compliance of chewing gum was investigated.Results The first anus exhaust time and the first defecation time of chewing gum group were (19.60±7.59) hours and (36.77±17.16) hours respectively,while those of the control group were (33.79±10.54)hours and (53.25±16.92) hours,and the differences were statistically significant(P0.05).The actual compliance investigation of chewing gum was selected in 53 cases with the actual completion of 48 cases(90.6%).The averaged actual chewing number was (4.39±1.35) times,the averaged actual chewing time in each duration was (16.16±2.05) minutes,the average actual chewing interval was (2.38±0.26) hours.Conclusion The well designed form of chewing gum postoperative can shorten the postoperative anus exhaust and defecation time, and it can reduce postoperative abdominal distention.
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Ryokito is a Kampo formulation which has been administered for right upper quadrant pain since the Edo Era in Japan. Yet there are but a few reported cases in multiple clinical exams at one institution, on the usage of this formulation. We undertook a precise retrospective analysis of ryokito-prescribed cases at our institute over ten years, and reported cases published in the past to illuminate the clinical characteristics of ryokito effective cases. <br>Among the 21 cases at our institute, ryokito was effective in 11 cases and 10 of these 11 cases had right upper quadrant pain. Additionally, 7 of them reported abdominal distention. <br>Overall, this retrospective analysis revealed that amongst those ryokito effective cases, not a few patients had the right upper quadrant pain. This fact suggests that right upper quadrant pain is a reasonable characteristic for a usage of ryokito. <br>Likewise, abdominal distention was also a common symptom among the effective cases. It is likely that abdominal distention could be a characteristic for a usage of ryokito as well.
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Objective To investigate the clinical efficacy of Zusanli moxibustion intervention in abdominal distention with enteral nutrition after stomach cancer surgery.Methods One hundred patients who had undergone stomach cancer surgery and received postoperative enteral nutrition were randomly allocated to treatment and control groups, 50 cases each. The control group received medication and the treatment group, Zusanli moxibustion in addition. Post-treatment incidences and grading scores of abdominal distention were compared between the two groups.Results The incidence of abdominal distention was 6.0% in the treatment group and 24.0% in the control group; there was a statistically significant difference between the two groups (P<0.05). The grading score of abdominal distention was (0.33±0.58) in the treatment group and (0.92±1.00) in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Zusanli moxibustion can effectively prevent the occurrence of abdominal distention in patients with enteral nutrition after stomach cancer surgery.
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Objective]To investigate the clinical efficacy of Yiqidaozhi decoction on spinal fracture dislocation patients postoperative abdominal distension pain. [Methods]From April 2012 to July 2014 the inpatient treatment of spinal fracture dislocation postoperative abdominal distension pain 172 cases patients,according to the random number table method combined with the admission number ,patients were divided into observation group(n=97) and control group(n=75),patients in observation group were given Yiqidaozhi decoction,while the control group was given conventional western medicine treatment,observed two groups patients after 48h treatment abdominal distension pain ,during the 5d treatment degree of pain and TCM syndrome integral improved etc.[Results]The observation group the total effective rate was 95.88%,significantly higher than 70.67%in the control group,the difference was statistically significant(P0.05);observation group treatment 1,2d TCM symptoms integral decline was obviously higher than that of the control group,the difference was statistically significant(P<0.05);The patients in the observation group treatment 1,2,3d VAS scores were (5.36±1.03) points,(4.56±0.95) points and (1.74±0.87) points respectively lower than that of the control group,the level of the same period,for the difference was statistically significant(P<0.05).[Conclusion]Yiqidaozhi Decoction on spinal fracture dislocation postoperative abdominal distention pain has better therapeutic effect ,and helps relieve pain.
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Objective: To observe the clinical effect of heat-sensitive moxibustion on abdominal distension following laparoscopic cholecystectomy. ＜br> Methods: A total of 240 cases were randomly allocated into an observation group and a control group according to their admission sequence, 120 in each group. Cases in the observation group were treated with conventional care, glycerol enema and heat sensitive moxibustion, whereas cases in the control group were only treated with conventional care and glycerol enema. Then the passage of gas by anus within 24 h and improvement of abdominal distension were observed in both groups. ＜br> Results: There were statistical differences in the emergence time of bowel sounds and the initial passage of gas by anus between the two groups (bothP＜0.05). The therapeutic effect in the observation group was better than that in the control group (P＜0.05) . ＜br> Conclusion: Heat-sensitive moxibustion has reliable effect for abdominal distension following laparoscopic cholecystectomy.
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We present a patient with short bowel syndrome (SBS), successfully treated with the Kampo medicine, shigyakuto-kagen. The patient was a 74 year old female complaining of severe diarrhea, abdominal distention, and abdominal pain. She was diagnosed as having tuberculous peritonitis when she 23 years of age. A partial resection of the small bowel and colon was performed for ileus, secondary to her tuberculous peritonitis, eventually causing her short bowel syndrome (SBS). Severe abdominal distention and pain had persisted even after the resection surgery. She consulted our clinic at 60 years of age in order to receive Kampo therapy. Bukuryoshigyakuto was prescribed, and her condition markedly improved. Zanthoxylum piperitum was added to bukuryoshigyakuto, and the regimen had the reactivity of daikenchuto. She regained her pre-operation body weight. It is significant that this case was followed for 14 years with therapy based on Kampo diagnosis, without remarkable complications, although patients with SBS often tend to have poor prognosis.
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Short Bowel Syndrome , Medicine, Kampo , PeritonitisABSTRACT
@#Objective To investigate the effect of fresh apple pulp on abdominal distention and constipation in patients with tube feeding.Methods 62 patients with tube feeding were divided into the observation group(n=31) and control group(n=31) randomly.The patients in the observation group were given routine enteral nutrition and fresh apple pulp,while those in the control group were given the routine enteral nutrition and rice soup.Results 3 cases developed abdominal distention in the observation group,but 10 cases in the control group(P<0.05).4 cases developed constipation in the observation group,but 12 cases in the control group(P<0.05).Moreover,the duration of abdominal distention and constipation significantly decreased in the observation group compared with those of the control group(P<0.05).Conclusion Fresh apple pulp can prevent and reduce abdominal distention and constipation in patients with tube feeding.
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The authors report a case of spontaneous perforation of the biliary tract (S.P.B.T) in a three-month-old infant. The diagnosis was suspected before the operation by clinical signs and diagnostic tests. The importance of paracentesis and scintigraphy is stressed. A surgical approach was chosen and drainage procedure of the area around the perforation and a cholecystostomy were done. S.P.B.T. is rare and its etiology is controversial, but cannot be forgotten in association between biliary ascites and cholestatic jaundice during the first months of life.
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Objective: Gynecological patients receiving abdominal surgery commonly experience bowel symptoms which result from impairment of bowel motility after the surgery. The purpose of this study was to identify abdominal distention symptom in gynecological patients receiving abdominal surgery. Methods: Gynecological patients who received elective abdominal surgery at Gynecological Unit, Obstetrics and Gynecological Department, Siriraj Hospital from December 2003 to February 2004 were recruited in this study. The data were collected five days after surgery by using Abdominal Distention Assessment Record for Gynecological Patient Receiving Abdominal Surgery which was applied from Abdominal Distention Assessment Record by Wattanawetch (2002). Abdominal distention was defined as belching, flatus excretion, perception of fullness, bowel sound, and difference of abdominal girth. The total score is ranged from 1 to 20 points. The severity of abdominal distention symptom is presented as: 1-10 points= mild abdominal distention; 10-15 points= moderate abdominal distention; 16-20 points= severe abdominal distention. The data were analyzed by using descriptive statistics. Results: All participants were hospitalized three days after surgery while 15.4% and 42.3% of them were discharged on the forth and the fifth day after surgery. Since the first through the third day after surgery, most of the participants experienced moderate to severe abdominal distention (PO day 1= 98.7%; PO day 2=93.6%; PO day 3= 67.9%). Most of the participants had no belching (61.5%) and no flatus excretion (83.3%), with mild to severe perception of fullness (50.0%); their bowel sound was less than three times per minute (88.5%), and the difference of abdominal girth was less than 1.3 centimeters (61.5%) on the first day after surgery. On the second day after surgery most of them were belching 1-5 times in the last 4 hours (55.1%), no flatus excretion (46.2%), with mild to severe perception of fullness (66.4%); their bowel sound was less than 3 times per minute (53.8%), and the difference of abdominal girth was less than 1.3 centimeters (57.7%). On the third day most of them were belching 1-5 times in the last 4 hours (59.0%); their flatus excretion was 1-3 times in the last 4 hours (50.0%), with mild perception of fullness (60.3%); their bowel sound was 3-5 times per minute (51.3%), and the difference of abdominal girth was less than 1.3 centimeters (73.1%). On the forth and on the fifth day after surgery, 1.3% and 2.6% of the participants still experienced severe abdominal distention symptom while 41% and 15.4% of them had moderate distention score. Conclusion: This study revealed that more than a half of the gynecological patients receiving abdominal surgery had moderate to severe abdominal distention after surgery. This indicates the need for an improvement of abdominal distention management program for gynecological patient receiving abdominal surgery.
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Herpes zoster has been rarely associated with somatic and visceral motor complications, including facial palsy, segmental motor paralysis of extremity, abdominal muscle weakness, neurogenic bladder dysfunction, and pseudo-obstruction. We report a case of unilateral abdominal distention due to muscle weakness after thoracic herpes zoster. The unnecessary tests and treatments for similar cases could be avoided with awareness of possibility of post-zoster motor weakness.