Changes

Medical treatment with fluids and liquid paraffin may resolve the impaction early on(36) but '''surgery''' is typically required.  At surgery, fluids such as saline or carboxymethylcellulose can be directly infused into the mass so that the impaction can be manually broken down and massaged into the caecum.  '''Dioctyl sodium sulfosuccinate (DSS)''' may be included in the infusion to help disrupt the mass.  An enterotomy in the distal jejunum should be considered to evacuate impacted contents and reduce intestinal manipulation.

Medical treatment with fluids and liquid paraffin may resolve the impaction early on(36) but '''surgery''' is typically required.  At surgery, fluids such as saline or carboxymethylcellulose can be directly infused into the mass so that the impaction can be manually broken down and massaged into the caecum.  '''Dioctyl sodium sulfosuccinate (DSS)''' may be included in the infusion to help disrupt the mass.  An enterotomy in the distal jejunum should be considered to evacuate impacted contents and reduce intestinal manipulation.

==Complications==

==Complications==

Extensive small intestinal distension and intraoperative manipulation of the ileum may lead to postoperative ileus(42) but the risk is reduced if the duration between disease onset and surgical intervention is decreased(35)

Extensive small intestinal distension and intraoperative manipulation of the ileum may lead to postoperative ileus(42) but the risk is reduced if the duration between disease onset and surgical intervention is decreased.(35)Depending on the degree of damage to the serosal surface of the small intestine at the time of surgery, complications may develop several weeks after surgery due to intra-abdominal adhesions.(Merck)

 

==Prognosis==

==Prognosis==