English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

[Objective] An air-fluid level (niveau) on abdominal X-ray is usually an important sign of ileus. We experienced two cases of ileus without air-fluid level following gynecologic surgery. Both patients underwent double-balloon enteroscopy for diagnosis, followed by laparoscopic adhesiolysis.[Case 1] The patient underwent total abdominal hysterectomy and right salpingo-oophrectomy for myoma uteri and right ovarian tumor. Five months later, she was readmitted with abdominal pain and constipation, but there was no air-fluid level on abdominal x-ray. Adhesion of the small bowel was diagnosed by enteroscopy. Laparoscopic adhesiolysis was performed. There was a 20 cm adhesion of the small bowel to the scar from the previous operation, but there was no stenosis or obstruction. Usually, a post-operative ileus is a mechanical ileus, but this case it was not only a mechanical ileus, but also a functional ileus because there was peristalsis abnormality.[Case 2] A patient who was being treated for depression underwent right adnexectomy for torsion of a right ovarian tumor. 16 months later, she was readmitted with lower abdominal pain and constipation without air-fluid levels. We initially suspected functional ileus because the patient was on antidepressants, but conservative therapy was not effective. Diagnostic enteroscopy revealed adhesion of the small bowel. Because of the enteroscopy results, laparoscopic surgery was selected and laparoscopic adhesiolysis between the ileum and retroperitoneum was performed.[Conclusion] When abdominal pain and constipation without air-fluid level are persistent, we must consider the possibility of ileus. Enteroscopy and laparoscopic adhesiolysis may be options in these cases.

Enteroscopy and laparoscopic adhesiolysis for two cases of adhesive ileus after gynecologic surgery