1.Risk factors for postoperative ileus.
Aybala Agac AY ; Suat KUTUN ; Haluk ULUCANLAR ; Oguz TARCAN ; Abdullah DEMIR ; Abdullah CETIN
Journal of the Korean Surgical Society 2011;81(4):242-249
PURPOSE: This study aimed to examine extended postoperative ileus and its risk factors in patients who have undergone abdominal surgery, and discuss the techniques of prevention and management thereof the light of related risk factors connected with our study. METHODS: This prospective study involved 103 patients who had undergone abdominal surgery. The effects of age, gender, diagnosis, surgical operation conducted, excessive small intestine manipulation, opioid analgesic usage time, and systemic inflammation on the time required for the restoration of intestinal motility were investigated. The parameters were investigated prospectively. RESULTS: Regarding the factors that affected the restoration of gastrointestinal motility, resection operation type, longer operation period, longer opioid analgesics use period, longer nasogastric catheter use period, and the presence of systemic inflammation were shown to retard bowel motility for 3 days or more. CONCLUSION: Our study confirmed that unnecessary analgesics use in patients with pain tolerance with non-steroid anti-inflammatory drugs, excessive small bowel manipulation, prolonged nasogastric catheter use have a direct negative effect on gastrointestinal motility. Considering that an exact treatment for postoperative ileus has not yet been established, and in light of the risk factors mentioned above, we regard that prevention of postoperative ileus is the most effective way of coping with intestinal dysmotility.
Analgesics
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Analgesics, Opioid
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Catheters
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Gastrointestinal Motility
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Humans
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Ileus
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Inflammation
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Intestine, Small
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Light
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Prospective Studies
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Risk Factors
2.Unusual Combination of Tracheobronchopathia Osteochondroplastica and AA Amyloidosis.
Gokhan KLRBAS ; Canan Eren DAGLL ; Abdullah Cetin TANRLKULU ; Fetin YLLDLZ ; Yasar BUKTE ; Abdurrahman SENYIGIT ; Esen KLYAN
Yonsei Medical Journal 2009;50(5):721-724
Tracheobronchopathia osteochondroplastica (TO) is a rare disorder of unknown cause characterized by the presence of multiple submucosal osseous and/or cartilaginous nodules that protrude into the lumen of the trachea and large bronchi. A simultaneous diagnosis of TO and amyloidosis is rarely reported. In this report, a case initially suspected to be asthma bronchiole that could not be treated, was radiologically diagnosed as TO, and also secondary amyloidosis is presented. A 53 years, man patient reported a 3 years history of dyspnea. Pulmonary function tests (PFTs) showed an obstructive pattern. Chest X-rays revealed right middle lobe atelectasis. FOB and CT detected nodular lesions in the trachea and in the anterior and lateral walls of the main bronchi. AA amyloidosis was confirmed by endobronchial biopsy. In the abdominal fat pad biopsy, amyloidosis was not detected. Asthma bronchiole was excluded by PFTs. This case illustrates that it is possible for TO and amyloidosis to masquerade as asthma. TO and amyloidosis should be suspected in patients of older ages with asthma and especially with poorly treated asthmatic patients. Although nodular lesions in the anterior and lateral tracheobronchial walls are typical for TO, a biopsy should be obtained to exclude amyloidosis.
Amyloidosis/complications/*diagnosis/pathology
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Asthma/diagnosis
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Bronchial Diseases/complications/*diagnosis/radiography
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Diagnosis, Differential
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Humans
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Male
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Middle Aged
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Tracheal Diseases/complications/*diagnosis/radiography