ORIGINAL RESEARCH
General Surgery
doi: 10.25005/2074-0581-2025-27-1-99-106
ACUTE ADHESIVE SMALL BOWEL OBSTRUCTION: ROLE OF DOPPLER ULTRASONOGRAPHY IN PATIENT MANAGEMENT

M.K. GULOV¹, D.S. SALIMOV¹, S.G. ALI-ZADE², D.K. MUKHABBATZODA¹, P.K. KHOLMATOV², K.K. KOBILOV³

1Department of General Surgery № 1 named after Prof. A.N. Kakhkhorov, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
2Department of Surgical Diseases № 1 named after Academician K.M. Kurbonov, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
3Department of Topographic Anatomy and Operative Surgery named after Prof. M.K. Karimov, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: To evaluate the role of Doppler ultrasonography (DUS) in selecting treatment strategies for patients with acute adhesive small bowel obstruction (ASBO).

Methods: This study presents a retrospective analysis of 169 patients diagnosed with acute ASBO. The average age of the patients was 55.2 years, with a standard deviation of 4.6 years. The gender distribution included 105 men and 64 women. The average duration of acute ASBO among the patients was 4.75 hours, with a standard deviation of 0.9 hours. The patients were divided into two groups to assess DUS parameters based on their treatment approach. The first group consisted of 98 patients who received conservative treatment, while the second group included 71 patients who underwent surgical interventions.

Results: An analysis of DUS parameters based on the time elapsed since the onset of acute ASBO revealed significant differences between two patient groups: those who underwent surgical intervention and those who received conservative treatment. In the initial stage (within the first 1-2 hours), blood flow parameters remained normal, indicating that compensatory mechanisms effectively maintained intestinal perfusion. However, between 2 and 5 hours, a decrease in Vs and Vm velocities was observed, which signaled the initial signs of ischemia. From 5 to 7 hours, in the absence of appropriate treatment, ischemia worsened, as evidenced by a notable deterioration in blood flow parameters and an increase in the resistive index (RI). At later stages (beyond 7 hours), severe ischemic changes and intestinal necrosis occurred without surgical intervention, necessitating urgent surgical correction. Monitoring changes in DUS parameters over time allows for a better assessment of the progression of ischemic changes in cases of acute ASBO.

Conclusion: DUS effectively monitors patients with acute ASBO, being an effective surgical decision-making tool.

Keywords: Acute adhesive small bowel obstruction, ultrasound examination, conservative treatment, surgical treatment.

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References
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Authors' information:

Gulov Makhmadshokh Kurbonalievich,
Doctor of Medical Sciences, Full Professor, Professor of the Department of General Surgery № 1 named after Prof. A.N. Kakhkhorov, Avicenna Tajik State Medical University
Researcher ID: D-7916-2018
Scopus ID: 6507730145
ORCID ID: 0000-0001-5151-937X
SPIN: 5463-6781
Author ID: 305733
E-mail: info@tajmedun.tj

Salimov Dzhamshed Saidakhmadovich,
Candidate of Medical Sciences, Associate Professor of the Department of General Surgery № 1 named after Prof. A.N. Kakhkhorov, Avicenna Tajik State Medical University
ORCID ID: 0000-0001-6396-2600
SPIN: 5488-8836
Author ID: 1073489
E-mail: salimov_jamshed1973@mail.ru

Ali-Zade Sukhrob Gaffarovich,
Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases № 1 named after Academician K.M. Kurbonov, Avicenna Tajik State Medical University
Researcher ID: B-6807-2019
ORCID ID: 0000-0002-2456-7509
SPIN: 6854-5343
Author ID: 258253
E-mail: suhrob_a@mail.ru

Mukhabbatzoda Dzhiyonkhon Kurbonovich,
Doctor of Medical Sciences, Professor of the Department of General Surgery № 1 named after Prof. A.N. Kakhkhorov, Avicenna Tajik State Medical University
ORCID ID: 0000-0002-2100-310X
SPIN: 8407-5820
Author ID: 390576
E-mail: mukhabbatov67@mail.ru

Kholmatov Pulat Kadyrovich,
Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases № 1 named after Academician K.M. Kurbonov, Avicenna Tajik State Medical University
ORCID ID: 0000-0001-8025-0832
SPIN: 8036-8010
Author ID: 467184
E-mail: kholmatuvpuk@mail.ru

Kobilov Kobildzon Kendzhaevich,
Candidate of Medical Sciences, Associate Professor of the Department of Topographic Anatomy and Operative Surgery named after Prof. M.K. Karimov, Avicenna Tajik State Medical University
ORCID ID: 0000-0002-9034-1022
SPIN: 8152-9937
Author ID: 1104897
E-mail: kobil76@mail.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medi- cines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Salimov Dzhamshed Saidakhmadovich
Candidate of Medical Sciences, Associate Professor of the Department of General Surgery № 1 named after Prof. A.N. Kakhkhorov, Avicenna Tajik State Medical University

734026, Republic of Tajikistan, Dushanbe, Sino str., 29-31

Tel.: +992 (907) 758510

E-mail: salimov_jamshed1973@mail.ru


This work is licensed under a Creative Commons Attribution 4.0 International License.

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