Underappreciated Cause of Bowel Obstruction Should Be Included in Surgical Assessments

 

May 06, 2015  |  

Each year, more than 10 million Americans seek medical attention, often in emergency situations, for symptoms of intestinal blockages. Researchers at the University California, San Diego School of Medicine have identified an abnormal form of small bowel twisting (or volvulus) that may cause these painful obstructions. In contrast to other causes of bowel obstruction that are treated with bowel rest, these require immediate surgical care.

Jason Sicklick

Jason Sicklick, MD, surgical oncologist, UC San Diego Health System.

Results of the study were published in the May online edition of The American Journal of Surgery.

“As the first population-based epidemiological study of small bowel volvulus in adults, our findings provide a robust representation of this infrequent cause of obstruction in American adults,” said Jason Sicklick, MD, assistant professor of surgery and surgical oncologist at UC San Diego Health System. “While relatively uncommon compared to other causes of bowel obstructions, surgeons should be aware of the potential for small bowel volvulus with or without intestinal malrotation in the adult population.”

Intestinal obstructions are often caused by post-surgical adhesions, tumors or hernias. However, in 1 percent of cases, patients may develop intestinal obstruction secondary to a small bowel volvulus (SBV). This condition involves the twisting of a loop of small bowel where vital arteries and veins reside. Initially, physicians may not consider SBV as a potential diagnosis as it is typically observed in newborns.

By being alert to the possibility of SBVs, said lead author Taylor Coe, doctors won’t necessarily have to wait for tell-tale signs of peritonitis, intestinal ischemia or failure of non-operative management, thus improving patient outcomes.

Sicklick and his team performed a retrospective analysis of the United States Nationwide Inpatient Sample spanning from 1998 -2010. More than 65 percent of the time, an operation was the prescribed treatment. Non-surgical approaches to management of SBV were associated with higher mortality.

David Chang, PhD, former director of outcomes research at UC San Diego also contributed to the study.


​Care at UC San Diego Health System



Media Contact

Jackie Carr
858-249-0456
jcarr@ucsd.edu

Share This Article


Related News

1/18/2017
Gastrointestinal stromal tumors (GIST) are tumors that arise is the wall of the digestive tract, and most often occur in the stomach or small intestine. Though more common in later in life, GISTs can ...
11/1/2016
Researchers at University of California San Diego School of Medicine and Mayo Clinic provide the first evidence that the Hedgehog signaling pathway is central to the formation of gastrointestinal stro ...
10/4/2016
Physician-scientists with Moores Cancer Center at UC San Diego Health have been leading the way in pancreatic cancer care by investigating new therapies as well as offering innovative clinical trials ...
5/4/2016
Researchers at University of California San Diego School of Medicine have shown that ozanimod (RPC1063), a novel drug molecule, is moderately effective in the treatment of ulcerative colitis. Results ...



Follow Us