RESUMO
Introduction: Shunt placement is an effective therapy for hydrocephalus. Ventriculoperitoneal shunt draining excess cerebrospinal fluid connects the cerebral ventricles to the abdominal cavity. However, intestinal obstruction may ensue as an infrequent complication of the shunt. Case presentation: A 65 years old female patient presented with abdominal pain, abdominal bloating, and ceased passage of flatus and stool for six days. She had a history of undergoing a VP shunt procedure due to midbrain obstruction and supratentorial hydrocephalus. Conservative treatment at another local hospital couldn't relieve her symptoms. Laboratory investigations revealed elevated CRP and neutrophils. CT scan showed distended small bowel loops with aerated effusion. Thus, she was admitted to our hospital and underwent an emergent laparotomy following diagnostic modalities completion. Discussion: Adhesive intestinal obstruction secondary to ventriculoperitoneal shunt is a rare but fatal shunt complication. The possible mechanisms involved include rubbing movements between the greater omentum and the catheter, cerebrospinal fluid reaction with abdominal organs, immunological rejection of the catheter, and deposition of brain tumor cells with the resultant abdominal metastatic lesions. Laparoscopic and laparotomy are warranted in the surgical management of the disease. Conclusion: A high index of suspicion for adhesive intestinal obstruction is key to timely diagnosis and treatment.
RESUMO
Maize straws were collected from different treatments of two long-term fertilization studies, their carbon (C)/nitrogen (N) ratios were determined, and their C and N mineralization rates in soil were compared in an aerobic incubation test. The results showed that comparing with no fertilization, applying chemical fertilizers (NPK) or chemical fertilizers plus manure (MNPK) increased the N content and decreased the C/N ratio of maize straw. The amounts of mineralized and immobilized C and N of the straws from different fertilization treatments differed with incubation time. The straws from treatments NPK, MNPK, and N240 had significantly higher C mineralization rates than that from the treatment without fertilization. After incubation for 60 days, the straw from treatment NPK had the highest C mineralization rate (13.24% of added organic C), and the immobilized N from the straws of fertilized plots, especially of MNPK plot, was lesser, compared to unfertilized plots. Adding maize straw into soil increased the metabolic quotient (qCO2) of soil microorganisms, but the difference among the treatments was not significant. During incubation, the amounts of soil microbial biomass C and N from different treatments differed with time. Therefore, in agricultural practices, the differences in the nutrient contents of straw due to different fertilization should be considered when the straw was to be added into soil.