The research progress of acute small bowel perforation
This article reviews the various aetiologies of small bowel perforations and their management. In addition to the well-known aetiologies such as trauma, inflammation and circulatory disorders, several new causes of small bowel perforation have been described in recent years. The spectrum reaches fro...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2015-08-01
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| Series: | Journal of Acute Disease |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2221618915000256 |
| _version_ | 1818911613680353280 |
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| author | Rudolf Schiessel |
| author_facet | Rudolf Schiessel |
| author_sort | Rudolf Schiessel |
| collection | DOAJ |
| description | This article reviews the various aetiologies of small bowel perforations and their management. In addition to the well-known aetiologies such as trauma, inflammation and circulatory disorders, several new causes of small bowel perforation have been described in recent years. The spectrum reaches from iatrogenic perforations during laparoscopic surgery or enteroscopies to drug-induced perforations with new anticancer agents. The management of small bowel perforations requires a concept consisting of the safe revision of the leaking bowel and the treatment of the peritonitis. Depending on the local situation and the condition of the patient, several treatment options are available. The surgical management of the bowel leak can range from a simple primary closure to a delayed restoration of bowel continuity. When the condition of the bowel or patient is frail, the risk of a failure of a closure or anastomosis is too high, and the exteriorization of the bowel defect as a primary measure is a safe option. The treatment of the peritonitis is also dependent on the condition of the patient and the local situation. Early stages of peritonitis can be treated by a simple peritoneal lavage, either performed by laparoscopy or laparotomy. Severe forms of peritonitis with multi-organ failure and an abdominal compartment syndrome need repeated peritoneal revisions. In such cases, the abdomen can only be closed temporarily. Different technical options are available in order to overcome the difficult care of these patients. |
| first_indexed | 2024-12-19T23:01:29Z |
| format | Article |
| id | doaj.art-28f937aebee2497999d9204e02eac9ec |
| institution | Directory Open Access Journal |
| issn | 2221-6189 |
| language | English |
| last_indexed | 2024-12-19T23:01:29Z |
| publishDate | 2015-08-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Acute Disease |
| spelling | doaj.art-28f937aebee2497999d9204e02eac9ec2022-12-21T20:02:29ZengWolters Kluwer Medknow PublicationsJournal of Acute Disease2221-61892015-08-014317317710.1016/j.joad.2015.04.002The research progress of acute small bowel perforationRudolf SchiesselThis article reviews the various aetiologies of small bowel perforations and their management. In addition to the well-known aetiologies such as trauma, inflammation and circulatory disorders, several new causes of small bowel perforation have been described in recent years. The spectrum reaches from iatrogenic perforations during laparoscopic surgery or enteroscopies to drug-induced perforations with new anticancer agents. The management of small bowel perforations requires a concept consisting of the safe revision of the leaking bowel and the treatment of the peritonitis. Depending on the local situation and the condition of the patient, several treatment options are available. The surgical management of the bowel leak can range from a simple primary closure to a delayed restoration of bowel continuity. When the condition of the bowel or patient is frail, the risk of a failure of a closure or anastomosis is too high, and the exteriorization of the bowel defect as a primary measure is a safe option. The treatment of the peritonitis is also dependent on the condition of the patient and the local situation. Early stages of peritonitis can be treated by a simple peritoneal lavage, either performed by laparoscopy or laparotomy. Severe forms of peritonitis with multi-organ failure and an abdominal compartment syndrome need repeated peritoneal revisions. In such cases, the abdomen can only be closed temporarily. Different technical options are available in order to overcome the difficult care of these patients.http://www.sciencedirect.com/science/article/pii/S2221618915000256Small bowel perforationAetiologiesTreatment |
| spellingShingle | Rudolf Schiessel The research progress of acute small bowel perforation Journal of Acute Disease Small bowel perforation Aetiologies Treatment |
| title | The research progress of acute small bowel perforation |
| title_full | The research progress of acute small bowel perforation |
| title_fullStr | The research progress of acute small bowel perforation |
| title_full_unstemmed | The research progress of acute small bowel perforation |
| title_short | The research progress of acute small bowel perforation |
| title_sort | research progress of acute small bowel perforation |
| topic | Small bowel perforation Aetiologies Treatment |
| url | http://www.sciencedirect.com/science/article/pii/S2221618915000256 |
| work_keys_str_mv | AT rudolfschiessel theresearchprogressofacutesmallbowelperforation AT rudolfschiessel researchprogressofacutesmallbowelperforation |