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Ileus and Intestinal Obstruction - Comparison Between Children and Adults

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Peyvasteh M., Askarpour S., Javaherizadeh H., Taghizadeh S.

Polish Journal of Surgery

2011

vol. 83

issue 7

367-371

Bowel obstruction is the interference with movement of bowel content. Large and small in testing from duodenum to anal region can be obstructed mechanical or non-mechanical and complete or partial. Mechanical obstruction can presented because of obstructive causes in intestinal lumen, intestinal wall or pressure from other tissue on intestine.The aim of the study was to evaluate etiology, laboratory findings of intestinal obstruction and ileus among children and adults who discharged with good condition.Material and methods. This retrospective study was carried out from 2001 to 2006 in Imam Khomeini Hospital (Ahvaz-Iran). Cases of bowel obstruction were included in this study. For each case, a questionnaire was filled. There are 752 cases with suspected bowel obstruction. From 752 cases, 403 patients that agreed and treated and discharged with good condition were studied. Cases were divided into two groups: children (age < 15 yrs) and adults (age> 15 yrs). Data were analyzed by SPSS Ver 16.0 (Chicago, IL, USA) and Epi-info Ver 6.00.Results. In our study, 221 adults and 192 children were included. Mortality rate was 12.2%. Forty-eight percent of 403 cases were children (m - 61%, f - 38%, ambigus genitalia - 1%) and 52% were adults (m - 67%, f - 33%). Etiology of bowel obstruction in children were as follows: ileus (26%); adhesion band (17.7%), partial obstruction (16.1%), and Hirschsprung's disease (12%). Causes of bowel obstruction in adults are: partial obstruction (29.9%); ileus (19%); adhesion band (18.5%); colonic pseudo obstruction(8.5%); GI cancer (5.2%); hernia (4.7%); Crohn (2.8%); fecal impaction (3.3%); bezoar (2.4%), and 4.7% for other causes. Fifty-one percent of children and 36% of adults were operated. Of all children, 91.7% had upright abdominal X-ray, 51.6% had supine X-ray, and 80.7% had sonography. Hundred percents of adults had upright & supine plain abdominal X-ray and 75.4% had sonography. Most change in children's CBC was 10000

Powikłania ze strony przewodu pokarmowego w trakcie leczenia klozapiną

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Wyskoński A.

Psychiatria i Psychologia Kliniczna

2015

vol. 15

issue 2

81-85

Clozapine is the ultimate therapeutic option for patients with treatment-resistant schizophrenia. Treatment with clozapine is often associated with gastrointestinal adverse reactions, such as: sialorrhea, constipations, bowel obstruction, liver failure (including fulminant hepatic failure), nausea and vomiting, increased appetite. This paper summarizes data on the incidence, mechanisms as well as preventive and therapeutic methods for sialorrhea, constipations and intestinal obstruction during treatment with clozapine. Several options may be used for the management of sialorrhea: clonidine, amitriptyline, pirenzepine and glycopyrrolate. Regarding constipations and obstruction, proper prevention (diet, physical activity) and the identification of patients at increased risk of these complications are particularly important. Patients receiving clozapine are exposed to a variety of gastrointestinal complications. Some of these (sialorrhea) may adversely affect the attitude towards treatment and lead to non-compliance. Other (e.g. intestinal obstruction) can be life-threatening and require intensive surgical treatment. For this reason, efforts should be made to detect modifiable risk factors, provide an early diagnosis of these complications and implement appropriate treatment.

Klozapina jest ostateczną opcją terapeutyczną w przypadku pacjentów ze schizofrenią oporną na leczenie. Podczas terapii często występują działania niepożądane ze strony przewodu pokarmowego: ślinotok, zaparcia, niedrożność jelit, niewydolność wątroby (również o piorunującym przebiegu), nudności i wymioty, wzmożenie apetytu. W pracy podsumowano informacje na temat częstości występowania, mechanizmów oraz metod profilaktyki i leczenia ślinotoku, zaparć i niedrożności jelit w przebiegu leczenia klozapiną. Gdy występuje ślinotok, stosuje się klonidynę, amitryptylinę, pirenzepinę i glikopirolan. W przypadku zaparć i niedrożności szczególne znaczenie mają: właściwa profilaktyka (dieta, aktywność fizyczna) oraz identyfikowanie pacjentów z grupy podwyższonego ryzyka. Chorzy przyjmujący klozapinę są narażeni na szereg powikłań ze strony przewodu pokarmowego. Niektóre z nich (ślinotok) mogą niekorzystnie wpływać na nastawienie do leczenia i powodować jego przerywanie, a inne (niedrożność przewodu pokarmowego) – zagrażać życiu i wymagać intensywnego leczenia chirurgicznego. Należy więc podejmować działania mające na celu wykrywanie modyfikowalnych czynników ryzyka, wczesne diagnozowanie powikłań i wdrażanie właściwego leczenia.

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1 Polish Journal of Surgery

1 Psychiatria i Psychologia Kliniczna

1 2015

1 2011

1 Askarpour S.

1 Javaherizadeh H.

1 Peyvasteh M.

1 Taghizadeh S.

1 Wyskoński A.

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Ileus and Intestinal Obstruction - Comparison Between Children and Adults

Powikłania ze strony przewodu pokarmowego w trakcie leczenia klozapiną