Concepts in Surgery of the Small Intestine and Appendix

  • Danielle M. FritzeEmail author
  • Jessemae L. Welsh
  • Joseph J. Cullen
  • Michael W. Mulholland


Multiple surgical diseases involve the small intestine or appendix and require knowledge relating to operations on the small bowel. This chapter introduces the concepts necessary to operate on the small bowel and appendix safely by discussing the operations in the context of common pathologic entities.


Small Bowel Hyaluronic Acid Acute Appendicitis Small Bowel Obstruction Laparoscopic Appendectomy 
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  1. Ahmad G, Duffy JM, Farquhar C, et al. Barrier agents for adhesion prevention after gynaecological surgery. Cochrane Database Syst Rev. 2008;(2):CD000475.Google Scholar
  2. Akobeng AK. Review article: the evidence base for interventions used to maintain remission in Crohn’s disease. Aliment Pharmacol Ther. 2008;27(1):11–8.PubMedCrossRefGoogle Scholar
  3. Bass KN, Jones B, Bulkley GB. Current management of small-bowel obstruction. Adv Surg. 1997;31:1–34.PubMedGoogle Scholar
  4. Becker JM, Dayton MT, Fazio VW, et al. Prevention of postoperative abdominal adhesions by a sodium hyaluronate-based bioresorbable membrane: a prospective, randomized, double-blind multicenter study. J Am Coll Surg. 1996;183:297–306.PubMedGoogle Scholar
  5. Bell Jr RH, Rikkers LF, Mulholland MW, editors. Digestive tract surgery: a text and atlas. Philadelphia: Lippincott Williams Wilkins; 1996.Google Scholar
  6. Brugger L, Rosella L, Candinas D, Guller U. Improving outcomes after laparoscopic appendectomy: a population-based, 12-year trend analysis of 7446 patients. Ann Surg. 2011;253(2):309–13.PubMedCrossRefGoogle Scholar
  7. Butela ST, et al. Performance of CT in detection of bowel injury. AJR Am J Roentgenol. 2001;176:129.PubMedCrossRefGoogle Scholar
  8. Cirocchi R, Abraha I, Farinella E, Montedori A, Sciannameo F. Laparoscopic versus open surgery in small bowel obstruction. Cochrane Database Syst Rev. 2010;(2):CD007511.Google Scholar
  9. Coursey CA, Nelson RC, Patel MB, et al. Making the diagnosis of acute appendicitis: do more preoperative CT scans mean fewer negative appendectomies? A 10-year study. Radiology. 2010;254(2):460–8.PubMedCrossRefGoogle Scholar
  10. Cullen JJ, et al. Surgical management of Meckel’s diverticulum. An epidemiologic population-based study. Ann Surg. 1994;220:564.PubMedCrossRefGoogle Scholar
  11. Dasari BV, McKay D, Gardiner K. Laparoscopic versus open surgery for small bowel Crohn’s disease. Cochrane Database Syst Rev. 2011;(1):CD006956.Google Scholar
  12. Dixon MR, Haukoos JS, Park IU, et al. An assessment of the severity of recurrent appendicitis. Am J Surg. 2003;186(6):718–22; discussion 722.PubMedCrossRefGoogle Scholar
  13. Doherty G, Bennett G, Patil S, Cheifetz A, Moss AC. Interventions for prevention of post-operative recurrence of Crohn’s disease. Cochrane Database Syst Rev. 2009;(4):CD006873.Google Scholar
  14. Duepree HJ, Senagore AJ, Delaney CP, Brady KM, Fazio VW. Advantages of laparoscopic resection for ileocecal Crohn’s disease. Dis Colon Rectum. 2002;45(5):605–10.PubMedCrossRefGoogle Scholar
  15. Fakhry SM, Watts DD, Luchette FA. Current diagnostic approaches lack sensitivity in the diagnosis of perforated blunt small bowel injury: analysis from 275,557 trauma admissions from the EAST multi-institutional HVI trial. J Trauma. 2003;54:295.PubMedCrossRefGoogle Scholar
  16. Fazio VW, Tjandra JJ. Strictureplasty for Crohn’s disease with multiple long strictures. Dis Colon Rectum. 1993;36(1):71–2.PubMedCrossRefGoogle Scholar
  17. Flum DR, Morris A, Koepsell T, Dellinger EP. Has misdiagnosis of appendicitis decreased over time? A population-based analysis. JAMA. 2001;286(14):1748–53.PubMedCrossRefGoogle Scholar
  18. Han SL, Cheng J, Zhou HZ, Guo SC, Jia ZR, et al. Surgically treated primary malignant tumor of small bowel: a clinical analysis. World J Gastroenterol. 2010;16:1527.PubMedCrossRefGoogle Scholar
  19. Kaminski A, Liu IL, Applebaum H, Lee SL, Haigh PI. Routine interval appendectomy is not justified after initial nonoperative treatment of acute appendicitis. Arch Surg. 2005;140(9):897–901.PubMedCrossRefGoogle Scholar
  20. Khaikin M, Schneidereit N, Cera S, et al. Laparoscopic vs. open surgery for acute adhesive small-bowel obstruction: patients’ outcome and cost-effectiveness. Surg Endosc. 2007;21(5):742–6.PubMedCrossRefGoogle Scholar
  21. Kibbe MR, Hassoun HT. Chapter 4. Acute mesenteric ischemia. In: ACS surgery: principles and practice. American College of Surgeons, Chicago, IL. WebMD. Accessed 15 Oct 2011.Google Scholar
  22. Meagher AP, Porter AJ, Rowland R, Ma G, Hoffmann DC. Jejunal diverticulosis. Aust N Z J Surg. 1993;63(5):360–6.PubMedCrossRefGoogle Scholar
  23. Michelassi F, Upadhyay GA. Side-to-side isoperistaltic strictureplasty in the treatment of extensive Crohn’s disease. J Surg Res. 2011;117: 71–8.CrossRefGoogle Scholar
  24. Oliak D, Yamini D, Udani VM, et al. Nonoperative management of perforated appendicitis without periappendiceal mass. Am J Surg. 2000;179(3):177–81.PubMedCrossRefGoogle Scholar
  25. Peyrin-Biroulet L, Deltenre P, Ardizzone S, et al. Azathioprine and 6-mercaptopurine for the prevention of postoperative recurrence in Crohn’s disease: a meta-analysis. Am J Gastroenterol. 2009;104(8): 2089–96.PubMedCrossRefGoogle Scholar
  26. Raman SS, Osuagwu FC, Kadell B, Cryer H, Sayre J, Lu DS. Effect of CT on false positive diagnosis of appendicitis and perforation. N Engl J Med. 2008;358(9):972–3.PubMedCrossRefGoogle Scholar
  27. Regueiro M, Schraut W, Baidoo L, et al. Infliximab prevents Crohn’s disease recurrence after ileal resection. Gastroenterology. 2009;136(2):441–450.e1; quiz 716.PubMedCrossRefGoogle Scholar
  28. Sauerland S, Jaschinski T, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev. 2010;(10):CD001546.Google Scholar
  29. Simillis C, Purkayastha S, Yamamoto T, Strong SA, Darzi AW, Tekkis PP. A meta-analysis comparing conventional end-to-end anastomosis vs. other anastomotic configurations after resection in Crohn’s disease. Dis Colon Rectum. 2007;50(10):1674–87.PubMedCrossRefGoogle Scholar
  30. Sporn E, Petroski GF, Mancini GJ, Astudillo JA, Miedema BW, et al. Laparoscopic appendectomy – is it worth the cost? Trend analysis in the US from 2000–2005. J Am Coll Surg. 2009;208:179–85.PubMedCrossRefGoogle Scholar
  31. Stocchi L, Milsom JW, Fazio VW. Long-term outcomes of laparoscopic versus open ileocolic resection for Crohn’s disease: follow-up of a prospective randomized trial. Surgery. 2008;144(4):622–7; discussion 627–8.PubMedCrossRefGoogle Scholar
  32. Talamonti MS, Goetz LH, Rao S, et al. Primary cancers of the small bowel. Arch Surg. 2002;137:564.PubMedCrossRefGoogle Scholar
  33. Tan JJ, Tjandra JJ. Laparoscopic surgery for Crohn’s disease: a meta-analysis. Dis Colon Rectum. 2007;50(5):576–85.PubMedCrossRefGoogle Scholar
  34. Tsiotos GG, Farnell MB, Ilstrup DM. Nonmeckelian jejunal or ileal diverticulosis: an analysis of 112 cases. Surgery. 1994;116(4):726–31; discussion 731–2.PubMedGoogle Scholar
  35. Uppal K, Shane Tubbs R, Matusz P, Shaffer K, Loukas M. Meckel’s diverticulum, a review. Clin Anat. 2011;24:416.PubMedCrossRefGoogle Scholar
  36. Wilson MS, Ellis H, Menzies D, Moran BJ, Parker MC, Thompson JN. A review of the management of small bowel obstruction. Members of the Surgical and Clinical Adhesions Research Study (SCAR). Ann R Coll Surg Engl. 1999;81(5):320–8.PubMedGoogle Scholar
  37. Wullstein C, Gross E. Laparoscopic compared with conventional treatment of acute adhesive small bowel obstruction. Br J Surg. 2003;90(9):1147–51.PubMedCrossRefGoogle Scholar
  38. Zulfikaroglu B, et al. Is incidental Meckel’s diverticulum resected safely? N Z Med J. 2008;121:39.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Danielle M. Fritze
    • 1
    Email author
  • Jessemae L. Welsh
    • 2
  • Joseph J. Cullen
    • 3
  • Michael W. Mulholland
    • 4
  1. 1.Department of SurgeryUniversity of MichiganAnn ArborUSA
  2. 2.Department of SurgeryUniversity of Iowa HospitalsIowa CityUSA
  3. 3.Department of SurgeryUniversity of Iowa Hospitals & ClinicsIowa CityUSA
  4. 4.Department of SurgeryUniversity of MichiganAnn ArborUSA

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