K Isaksson1, E Weber2, R Andersson2, B Tingstedt2. 1. Department of Surgery, University of Lund, University Hospital of Lund, 221 85, Lund, Sweden. karolin.isaksson@med.lu.se. 2. Department of Surgery, University of Lund, University Hospital of Lund, 221 85, Lund, Sweden.
Abstract
AIM: To study and identify early clinical and radiological findings that could help to predict operative intervention for small bowel obstruction. MATERIALS AND METHODS: One hundred and nine consecutive patients with small bowel obstruction who underwent small bowel follow-through examination with Gastrografin(®) during 2005-2006. The patients were divided into an operative group and a non-operative group, n = 44 and 65, respectively. Findings primarily noted were those which were possible to register within 1-4 h from hospital arrival. RESULTS: In univariate analyses, factors found to be significantly associated with surgical intervention were no prior abdominal surgery, the presence of radiological differential air fluid levels, and absence of flatulence 24 h prior to admission, CRP > 10 mg/L and dehydration at admission. In multivariate analyses, the presence of dehydration and radiological differentiated air fluid levels were independent predictive factors of significance. Absence of all factors significantly favored non-operative treatment, while operative treatment was significantly favored when two or more factors were present. CONCLUSIONS: The presence of two or more early predictive factors as defined above, available at admission, significantly correlates with a likelihood of complete obstruction and the need of surgical intervention.
AIM: To study and identify early clinical and radiological findings that could help to predict operative intervention for small bowel obstruction. MATERIALS AND METHODS: One hundred and nine consecutive patients with small bowel obstruction who underwent small bowel follow-through examination with Gastrografin(®) during 2005-2006. The patients were divided into an operative group and a non-operative group, n = 44 and 65, respectively. Findings primarily noted were those which were possible to register within 1-4 h from hospital arrival. RESULTS: In univariate analyses, factors found to be significantly associated with surgical intervention were no prior abdominal surgery, the presence of radiological differential air fluid levels, and absence of flatulence 24 h prior to admission, CRP > 10 mg/L and dehydration at admission. In multivariate analyses, the presence of dehydration and radiological differentiated air fluid levels were independent predictive factors of significance. Absence of all factors significantly favored non-operative treatment, while operative treatment was significantly favored when two or more factors were present. CONCLUSIONS: The presence of two or more early predictive factors as defined above, available at admission, significantly correlates with a likelihood of complete obstruction and the need of surgical intervention.
Entities:
Keywords:
Differentiated air fluid levels; Predictive value; Small bowel follow-through; Small bowel obstruction
Authors: H Ellis; B J Moran; J N Thompson; M C Parker; M S Wilson; D Menzies; A McGuire; A M Lower; R J Hawthorn; F O'Brien; S Buchan; A M Crowe Journal: Lancet Date: 1999-05-01 Impact factor: 79.321
Authors: Lucas W Thornblade; Francys C Verdial; Matthew A Bartek; David R Flum; Giana H Davidson Journal: J Gastrointest Surg Date: 2019-02-20 Impact factor: 3.452