Strangulation Intestinal Obstruction: the Problem of Diagnosis and Tactics of a General Practitioner

Acute intestinal obstruction is a common problem in abdominal surgery, occupying a special place among all other acute diseases of the abdominal organs requiring emergency surgical care. A large number of works devoted to the diagnosis, treatment and prevention of intestinal obstruction can be found in the literature; despite this, hospital mortality reaches up to 6% among patients seeking treatment for this pathology, the majority of whom are patients with strangulation obstruction.

Objective. To systematize current data concerning the problems of etiopathogenesis, clinical presentation, diagnosis and treatment of strangulation ileus.

The main material for writing the review consisted of publications by Russian and foreign authors available in specialized databases (PubMed, Scopus, eLibrary) over the past 10 years. The most complex form of acute intestinal obstruction is still considered to be strangulation ileus, which occurs due to compression of the mesentery supplying the intestine. The "gold standard" of instrumental diagnosis currently remains double-contrast tomography, the results of which determine the choice of surgical operation, which is the only treatment method for strangulation obstruction.

Difficulties in conducting differential diagnosis at the stage of history taking and manual examination methods require a more detailed study and search for pathognomonic signs that would allow distinguishing obstructive ileus from strangulation ileus at the prehospital and early hospital stages.

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