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Over half of the cases required surgery; of these 25 cases (51%), 8 cases involved a resection of the restricted loop and included a temporary colostomy (16%), 5 cases were exploratory laparotomy (10%), and there was 1 case with enterolysis (2%).
Other intraoperative abdominal manipulations included intraoperative simultaneous enterolysis, cholecystectomy, gastrostomy, intravesical fistula repair, and small intestine repair.
Although some authors reported that perinectomy and enterolysis (PEEL) could be the first option for the management of EPS [15, 17], we believe that it may not relieve patient symptoms and could lead to more complications.
We present the perioperative management of a 5-year-old boy with intestinal obstruction and two episodes of cerebral haemorrhage who presented for pheochromocytoma resection and enterolysis. Important issues in the management of this patient included choice of vasoactive agents and anaesthetics, control of blood pressure and intracranial pressure, preioperative fluid management, and monitoring technique.
We found the main route to the abdominal cavity, and then we did laparotomy and enterolysis. The tract ended in the anterior wall of the uterus.
Upon entering the abdominal cavity, enterolysis was performed to free the transverse colon from the hernia sac.
Third, operations included incision of perianal abscess, anal fistula fix, intestinal anastomosis, total intraabdominal colectomy, ileostomy, intestine exteriorization, transverse colostomy, sigmoidectomy, Hartmann's rectum resection, enterolysis, and exploratory laparotomy.
With excision and ablation of the capsules, complete enterolysis is finally achieved (b).
Operatively, we have utilized minilaparoscopic instrumentation for excision of endometriosis, ovarian cystectomy, adhesiolysis, enterolysis, tuboplasty, and supracervical and total hysterectomy with or without bilateral salpingo-oophorectomy.
Bowel surgery was defined as right hemicolectomy, lysis of adhesions (enterolysis), small bowel resection (entrectomy), colectomy with colostomy, closure of colostomy, closure of ileostomy, partial colectomy with anastomosis, or low anterior resection.
(15) Damage can occur during insertion of the Veress needle or trocar when the bowel is immobilized by adhesions, or during enterolysis. (16) Unrecognized thermal injury can cause delayed bowel injury.
In a study of 259 patients undergoing laparotomy for bowel resection or enterolysis, the incidence of repeat bowel obstruction was similar in the group treated with Seprafilm and the historical control group.