• Title/Summary/Keyword: Air enema

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Repeated Postoperative Adhesive Small Bowel Obstruction Treated with Daeseunggi-tang and Acupuncture Treatment in Elderly: A Case Report

  • Hyun-sik Seo;Sul-Ki Kim;Chang-Gue Son
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.37 no.1
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    • pp.19-24
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    • 2023
  • Postoperative adhesive small bowel obstruction (ASBO) is an intractable disorder which sometimes leads to adhesiolysis or small bowel resection. These therapeutic reoperations, however, also have many limitations including complications. An 80-year-old female, who had undergone 4-abdominal surgeries, visited the hospital with continuous vomiting. Based on her clinical symptoms and history, multiple air-fluid levels and distention of the small bowel in an abdominal X-ray, we diagnosed her with postoperative incomplete ASBO. We conducted acupuncture and an herbal medicine enema to stimulate bowel movement and relieve pain. The patient came in complaining of abdominal pain and vomited more than 10 times on hospital day 0 stopping on hospital day 4. Comparing hospital day 0 with hospital day 4, the abdominal pain decreased from a numerical rating scale (NRS) 10 to 4. There were no side effects such as redness or burns during the treatment process. This study presented an acupuncture-based treatment will be helpful for clinicians managing cases of ASBO with poor performance in elderly individuals.

Clinical Significance of Repeated Delayed Air Reduction in Unsuccessful Initial Reduction of Intussusception (초기 정복에 실패한 장중첩증 환자에서 반복 지연 정복술의 임상적 의의)

  • Shin, Song-Heui;Rho, Young-Il;Park, Young-Bong;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.175-180
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    • 2001
  • Purpose: The advantages of air reduction are the ease of performing the procedure, reduced radiation time and lower morbidity rate if perforation occurs. But, patients who fail air reduction undergo a laparotomy at which 10% have spontaneously reduced. The first enema decreases the edema and venous congestion of bowel wall, thus repeated reduction may succeed. The aim of this study is to evaluate the efficacy of delayed repeated pneumatic reduction of intussusception in patients with failure of an initial attempt. Methods: Between January 1998 and December 1999, 21 patients with proven intussusception received repeated delayed reduction 1 to 3 hours following the first failed attempt. These patients were in stable condition and did not have peritonitis, shock or toxic sign. Results: Before reduction, the patients had symptoms and signs for 6 to 48 hours (median 24 hr). The interval from the first reduction to the repeated was 1 to 3 hours (median 2.2 hr). The success rate of repeated reductions was 76.2% (16 of 21 patients), and 23.8% (5 of 21 patients) required surgery. Four of 5 patients requiring surgery were manually reduced and 1 spontaneously reduced in the operating room. Conclusion: We recommended a repeated reduction in patients with intussusception who are in stable clinical condition after an unsuccessful initial reduction attempt.

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