Mayumi Ozawa1, Atsushi Ishibe2, Yusuke Suwa3, Kazuya Nakagawa2, Masashi Momiyama2, Jun Watanabe3, Shigeru Yamagishi2, Kazumi Kubota4, Itaru Endo2. 1. Department of Gastroenterological Surgery, Yokohama City University Graduate School Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. myukku12@gmail.com. 2. Department of Gastroenterological Surgery, Yokohama City University Graduate School Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. 3. Department of Surgery Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan. 4. Department of Biostatistics, Yokohama City University Graduate School Medicine, Yokohama, Japan.
Abstract
PURPOSES: The diagnosis of strangulated bowel obstruction (SBO) is sometimes difficult. We attempted to create and verify a discriminant formula for use as a diagnostic aid for the early diagnosis of SBO. METHODS: This retrospective study included 97 patients who underwent an operation for SBO from January 2007 to September 2018. First, a discriminant analysis was performed for 73 patients who underwent an operation from January 2007 to December 2015 in order to obtain a formula. Next, we analyzed 34 patients who underwent an operation from January 2016 to September 2018 to verify the formula. RESULTS: The risk factors for SBO included ascites, signs of preperitoneal irritation, and lactate > 1.16 mmol/L. The discriminant formula is as follows: 1.954 × collection of ascites (1 or 0) + 1.239 × peritoneal irritation sign (1 or 0) + 0.378 × lactate - 2.331 (1: positive, 0: negative). The predictive value was as follows: sensitivity, 87.5%; specificity, 64.7%; and predictive accuracy, 73.5%. In patients who presented within 24 h of the onset, the sensitivity was 92.3%, the specificity was 75.0%, and the predictive accuracy was 85.7%. CONCLUSION: Our discriminant formula seems useful for the rapid diagnosis of SBO.
PURPOSES: The diagnosis of strangulated bowel obstruction (SBO) is sometimes difficult. We attempted to create and verify a discriminant formula for use as a diagnostic aid for the early diagnosis of SBO. METHODS: This retrospective study included 97 patients who underwent an operation for SBO from January 2007 to September 2018. First, a discriminant analysis was performed for 73 patients who underwent an operation from January 2007 to December 2015 in order to obtain a formula. Next, we analyzed 34 patients who underwent an operation from January 2016 to September 2018 to verify the formula. RESULTS: The risk factors for SBO included ascites, signs of preperitoneal irritation, and lactate > 1.16 mmol/L. The discriminant formula is as follows: 1.954 × collection of ascites (1 or 0) + 1.239 × peritoneal irritation sign (1 or 0) + 0.378 × lactate - 2.331 (1: positive, 0: negative). The predictive value was as follows: sensitivity, 87.5%; specificity, 64.7%; and predictive accuracy, 73.5%. In patients who presented within 24 h of the onset, the sensitivity was 92.3%, the specificity was 75.0%, and the predictive accuracy was 85.7%. CONCLUSION: Our discriminant formula seems useful for the rapid diagnosis of SBO.