Determining the need for surgery in small bowel obstructions based on clinical, laboratory, and radiological parameters.

OBJECTIVE: Small bowel obstruction (SBO) is a common and important surgical emergency. Our aim in this study is to describe the clinical, laboratory, and computed tomography (CT) findings to facilitate the objective identification of SBO patients in need of operative treatment in this patient population. METHODS: This retrospective study included 340 patients hospitalized due to a preliminary diagnosis of ileus. Retrieved data of patients included age, gender, comorbidities, previous hospitalization due to ileus, surgical history, physical examination findings, complete blood count and biochemistry test results, and CT findings at admission. RESULTS: The study included 180 (52.9%) male and 160 (47.1%) female patients. Treatment was conservative in 216 patients and surgery in 124 patients. Of the patients included in the study, 36.4% needed surgery. Of the female patients, 38.90% received conservative treatment and 61.30% underwent surgery. Adhesions were the most common cause of obstruction in operated patients (43.50%). CONCLUSION: We have found that female gender, vomiting, guarding, rebound, C-reactive protein levels above 75 mg/L, increased bowel diameter, and a transition zone on CT images indicate a strong need for surgery, but a history of previous hospitalization for ileus may show that surgery may not be the best option.

OBJETIVO: Describir los hallazgos clínicos, de laboratorio y de tomografía computarizada (TC) para facilitar la identificación objetiva de los pacientes con obstrucción del intestino delgado que necesitan tratamiento quirúrgico. MÉTODO: Este estudio incluyó 340 pacientes. Los datos obtenidos fueron edad, sexo, comorbilidad, hospitalización previa debida a íleo, historia quirúrgica, hallazgos de la exploración física, hemograma completo y resultados de las pruebas bioquímicas, y hallazgos de la TC al ingreso. RESULTADOS: El estudio incluyó 180 (52.9%) varones y 160 (47.1%) mujeres. El tratamiento fue conservador en 216 pacientes y quirúrgico en 124 pacientes. De los pacientes incluidos en el estudio, el 36.4% necesitaron cirugía. De las mujeres, el 38.90% recibieron tratamiento conservador y el 61.30% se sometieron a cirugía. CONCLUSIONES: Encontramos que el sexo femenino, los vómitos, la guardia, el rebote, los niveles de proteína C reactiva superiores a 75 mg/l, el aumento del diámetro intestinal y una zona de transición en las imágenes de TC indican una fuerte necesidad de cirugía.

Correção de complicação do uso de sonda nasoesofágica em gato-do-mato-pequeno (Leopardus guttulus) / Correction of a complication of the use of a nasoesophageal feeding tube in a Southern Tiger Cat (Leopardus guttulus)

Background: The southern tiger cat (Leopardus guttulus) is a vulnerable wild felid whose occurrence is restricted to theAtlantic Forest biome of Brazilian South and Southwest regions. Various strategies must be used to improve the conservation of species of felids, including preservation of forests and greater therapeutic support for animals in poor healthcondition. Enteral nutrition through a nasoesophageal tube is an option for patients in poor or critical condition; however,this procedure carries the risk of accidental ingestion of the tube. The objective of this work is to describe a conservativeapproach for the management of ingestion of a linear foreign body in a Leopardus guttulus patient.Case: A young female southern tiger cat was taken for veterinary treatment. The patient had an estimated age of nine weeks,0.846 kg of body weight, and exhibited cachexia, hypothermia, severe dehydration, and apathy. During the examination,blood samples were taken, and initial treatment commenced with fluid therapy, antibiotic therapy, and anti-inflammatorytherapy along with administration of analgesics and a gastric protector. Since the patient did not want to eat, it received anasoesophageal feeding tube under mild sedation. The patient was positioned in sternal recumbency, its head was tiltedup, and a no. 6 nasoesophageal tube was ventromedially inserted through the right nostril. The tube was later confirmedto be correctly positioned at the ninth intercostal space by a radiographic study. The feeding tube allowed administrationof drugs and microenteral nutrition with a hypercaloric diet; this minimized handling of the patient, which preserved itswild behavior. After the seventh day of treatment, a piece of the tube was found lying at the bottom of the cage. Sinceingestion of the remainder of the tube by the patient was suspected, it was taken to the diagnostic imaging division. At theultrasonographic exam, the stomach exhibited hypermotility and...(AU)

Correção de complicação do uso de sonda nasoesofágica em gato-do-mato-pequeno (Leopardus guttulus) / Correction of a complication of the use of a nasoesophageal feeding tube in a Southern Tiger Cat (Leopardus guttulus)

Background: The southern tiger cat (Leopardus guttulus) is a vulnerable wild felid whose occurrence is restricted to theAtlantic Forest biome of Brazilian South and Southwest regions. Various strategies must be used to improve the conservation of species of felids, including preservation of forests and greater therapeutic support for animals in poor healthcondition. Enteral nutrition through a nasoesophageal tube is an option for patients in poor or critical condition; however,this procedure carries the risk of accidental ingestion of the tube. The objective of this work is to describe a conservativeapproach for the management of ingestion of a linear foreign body in a Leopardus guttulus patient.Case: A young female southern tiger cat was taken for veterinary treatment. The patient had an estimated age of nine weeks,0.846 kg of body weight, and exhibited cachexia, hypothermia, severe dehydration, and apathy. During the examination,blood samples were taken, and initial treatment commenced with fluid therapy, antibiotic therapy, and anti-inflammatorytherapy along with administration of analgesics and a gastric protector. Since the patient did not want to eat, it received anasoesophageal feeding tube under mild sedation. The patient was positioned in sternal recumbency, its head was tiltedup, and a no. 6 nasoesophageal tube was ventromedially inserted through the right nostril. The tube was later confirmedto be correctly positioned at the ninth intercostal space by a radiographic study. The feeding tube allowed administrationof drugs and microenteral nutrition with a hypercaloric diet; this minimized handling of the patient, which preserved itswild behavior. After the seventh day of treatment, a piece of the tube was found lying at the bottom of the cage. Sinceingestion of the remainder of the tube by the patient was suspected, it was taken to the diagnostic imaging division. At theultrasonographic exam, the stomach exhibited hypermotility and...