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Surgery is indicated in cases of gastric outlet obstruction in which there is significant obstruction and in cases where medical therapy has failed. [citation needed] Endoscopic balloon therapy may be attempted as an alternative to surgery, with balloon dilation reporting success rates of 76% after repeat dilatons. [4]
Ileus is a disruption of the normal propulsive ability of the intestine. It can be caused by lack of peristalsis or by mechanical obstruction . [ 1 ] The word 'ileus' derives from Ancient Greek εἰλεός (eileós) 'intestinal obstruction'.
It is a common symptom of gastrojejunocolic fistula and intestinal obstruction in the ileum. [ 1 ] [ 2 ] Fecal vomiting is often accompanied by gastrointestinal symptoms, including abdominal pain , abdominal distension , dehydration , and diarrhea .
Many patients are diagnosed late in the course of disease after additional symptoms are seen. Mortality is also difficult to accurately determine. One retrospective study estimated mortality to be between 10 and 25% for chronic intestinal pseudo-obstruction (CIPO) and to vary greatly depending on the etiology of the condition. [5]
Foreign bodies (e.g. gallstones in gallstone ileus, swallowed objects such as expandable water toys) Intestinal atresia; Urinary retention; After abdominal surgery, the incidence of small bowel obstruction from any cause is 9%. In those where the cause of the obstruction was clear, adhesions are the single most common cause (more than half). [22]
Gallstone ileus is a rare form of small bowel obstruction caused by an impaction of a gallstone within the lumen of the small intestine. Such a gallstone enters the bowel via a cholecysto - enteric fistula .
Surgery may follow neoadjuvant chemotherapy, which aims to shrink the tumor and increase the likelihood of complete resection. [8] Post-operative death and complications associated with pancreaticoduodenectomy have become less common, with rates of post-operative mortality falling from 30 to 10% in the 1980s to less than 5% in the 2000s. [9]
[9] [10] [8] The long-term prognosis for patients with CIPO is dismal. Chronic abdominal discomfort can lead to opiate dependence for many patients. [27] In a long-term study of 59 patients with CIPO, 4 died from disease-related complications and 4 had small bowel transplant. [10]