LETHALITY ANALYSIS IN PATIENTS WITH ACUTE SMALL BOWEL OBSTRUCTION. ADVERSE FACTORS AND POSSIBLE WAYS TO ELIMINATE THEM

Abstract

The aim: To determine obstruction factors that can lead to lethal consequences for patients with acute small intestine in order to develop possible directions for their prevention. Materials and methods: During the retrospective analysis of 30 patients with acute small bowel obstruction, the causes and contributing factors of mortality were determined. Results: The cause of mortality in the $rst three days of the postoperative period was the progression of the phenomena of intoxication, which led to the appearance of the syndrome of enteric insu%ciency and the development of multiple organ dysfunction. Mortality in the later period was observed due to the decompensation of concomitant diseases that accompanied acute obstruction of the small intestine. In the process of the study it was determined that the possible reasons of the postoperative complications in the studied group of patients, apart from the elderly and senile age of the patients and delayed medical care, according to the results of our observation were: uncorrected hypotension and hypovolemia in the postoperative period, refusal of the intubation of the small intestine and permanent decompression of the gastrointestinal tract, early removal of the nasogastric tube, long-term anemia and hypoproteinemia, prevention of stress ulcers of the gastrointestinal tract in the elderly and senile age, refusal of early use of enteral nutrition and later restoration of motility of the gastrointestinal tract. Conclusions: Treatment of patients with acute small intestine obstruction requires the selection of a specially designed treatment program (optimal timing of preoperative preparation, selection of the minimum volume) at all stages of surgical care, taking into account the existing concomitant pathology, age and hospitalization period.