OBJECTIVETo evaluate the role of the small intestinal decompression tube (SIDT) and Gastrografin in the treatment of early postoperative inflammatory small bowel obstruction (EPISBO).

METHODSTwelve patients presented EPISBO after abdominal surgery in our department from April 2011 to July 2012. Initially, nasogastric tube decompression and other conventional conservative treatment were administrated. After 14 days, obstruction symptom improvement was not obvious, then the SIDT was used. At the same time, Gastrografin was injected into the small bowel through the SIDT in order to demonstrate the site of obstruction of small bowel and its efficacy.

RESULTSIn 11 patients after this management, obstruction symptoms disappeared, bowel function recovered within 3 weeks, and oral feeding occurred gradually. Another patient did not pass flatus after 4 weeks and was reoperated. After postoperative follow-up of 6 months, no case relapsed with intestinal obstruction.

CONCLUSIONFor severe and long course of early postoperative inflammatory intestinal obstruction, intestinal decompression tube plus Gastrografin is safe and effective, and can avoid unnecessary reoperation.

Decompression ; Diatrizoate Meglumine ; therapeutic use ; Humans ; Intestinal Obstruction ; drug therapy ; Intestine, Small ; Intubation, Gastrointestinal ; Postoperative Complications ; Postoperative Period ; Prospective Studies ; Reoperation

Infection cases of diphyllobothriid tapeworms are not much in the below teen-age group. We report a case of Diphyllobothrium nihonkaiense infection in a 13-year-old boy. He presented with severe fatigue, occasional abdominal pain at night time. He also had several episodes of tapeworm segment discharge in his stools. By his past history, he had frequently eaten raw fish including salmon and trout with his families. Numerous eggs of diphyllobothriid tapeworm were detected in the fecal examination. We introduced amidotrizoic acid as a cathartic agent through nasogastroduodenal tube and let nearly whole length (4.75 m) of D. nihonkaiense be excreted through his anus. After a single dose of praziquantel, the child's stool showed no further eggs, and his symptoms disappeared. The evacuated worm was identified as D. nihonkaiense by mitochondrial cox1 gene analysis. Here we report a successful extracorporeal worm extraction from an infection case of D. nihonkaiense by the injection of amidotrizoic acid.
Adolescent ; Animals ; Antiparasitic Agents/*therapeutic use ; Cyclooxygenase 1/genetics ; Diatrizoate Meglumine/*therapeutic use ; Diphyllobothriasis/*drug therapy/parasitology/pathology ; Diphyllobothrium/classification/*drug effects/genetics/*isolation & purification ; Feces/parasitology ; Humans ; Male ; Praziquantel/therapeutic use ; Sequence Analysis, DNA