Analysis of clinical diagnosis and treatment in 43 cases of adult small intestinal torsion / 中国医师进修杂志

ABSTRACT

Objective@#To investigate the diagnosis and treatment of adult small bowel torsion in order to improve early diagnosis and improve prognosis.@*Methods@#Clinical data of 43 cases of small bowel torsion from January 2012 to December 2017 were collected. All of them were confirmed by surgery as small bowel torsion. After admission, white blood cell count > 18 × 109/L was found in 5 patients; and hemoglobin<100 g/L was found in 5 patients; abdomen CT examination in 39 patients showed 33 cases had intestinal torsion; 14 cases suggested possible mesenteric and root torsion.@*Results@#All patients underwent surgical treatment. During the operation, there were 11 cases with intestinal torsion ≥ 720°; 13 cases underwent simple bowel torsion in surgical operation; 4 cases underwent decompression combined with reduction of the bowel; 1 case was treated with reduction and jejunostomy; and small intestine resection was performed for intestinal necrosis. Twenty-two patients had small bowel resection and jejunostomy was performed in 3 cases. The small intestine was resected 7-240 cm, with an average of about 66 cm.@*Conclusions@#Small bowel torsion should be diagnosed and operated as soon as possible. The suspected necrotic bowel should be removed and more healthy intestine should be reserved. The patient′s vital signs should be observed dynamically after operation to prevent the occurrence of intestinal necrosis and septic shock, to avoid excessive intestinal necrosis that would lead to postoperative short bowel syndrome, and to improve the patient's cure rate and reduce hospital stay.