Detected peritoneal fluid in small bowel obstruction is associated with the need for surgical intervention.

Hdl Handle:
http://hdl.handle.net/10147/94219
Title:
Detected peritoneal fluid in small bowel obstruction is associated with the need for surgical intervention.
Authors:
O'Daly, Brendan J; Ridgway, Paul F; Keenan, Niamh; Sweeney, Karl J; Brophy, David P; Hill, Arnold D K; Evoy, Denis; O'Higgins, Niall J; McDermott, Enda W M
Affiliation:
Surgical Professorial Unit, St Vincent'sUniversity Hospital, Elm Park, Dublin, Ireland.
Citation:
Detected peritoneal fluid in small bowel obstruction is associated with the need for surgical intervention. 2009, 52 (3):201-6 Can J Surg
Journal:
Canadian journal of surgery. Journal canadien de chirurgie
Issue Date:
Jun-2009
URI:
http://hdl.handle.net/10147/94219
PubMed ID:
19503664
Abstract:
BACKGROUND: Predicting the clinical course in adhesional small bowel obstruction is difficult. There are no validated clinical or radiologic features that allow early identification of patients likely to require surgical intervention. METHODS: We conducted a retrospective review of 100 patients consecutively admitted to a tertiary level teaching hospital over a 3-year period (2002-2004) who had acute adhesional small bowel obstruction and underwent computed tomography (CT). The primary outcomes that we assessed were conservative management or the need for surgical intervention. We investigated time to physiologic gastrointestinal function recovery as a secondary outcome. We examined independent predictors of surgical intervention in a bivariate analysis using a stepwise logistic regression analysis. RESULTS: Of the 100 patients investigated, we excluded 12. Of the 88 remaining patients, 58 (66%) were managed conservatively and 30 (34%) underwent surgery. Peritoneal fluid detected on a CT scan (n = 37) was associated more frequently with surgery than conservative management (46% v. 29%, p = 0.046, chi(2)). Logistical regression identified peritoneal fluid detected on a CT scan as an independent predictor of surgical intervention (odds ratio 3.0, 95% confidence interval 1.15-7.84). CONCLUSION: The presence of peritoneal fluid on a CT scan in patients with adhesional small bowel obstruction is an independent predictor of surgical intervention and should alert the clinician that the patient is 3 times more likely to require surgery.
Language:
en
MeSH:
Aged; Aged, 80 and over; Ascitic Fluid; Cohort Studies; Female; Gastrointestinal Transit; Humans; Intestinal Obstruction; Intestine, Small; Male; Middle Aged; Predictive Value of Tests; Recovery of Function; Retrospective Studies; Tomography, X-Ray Computed; Treatment Outcome
ISSN:
1488-2310

Full metadata record

DC FieldValue Language
dc.contributor.authorO'Daly, Brendan Jen
dc.contributor.authorRidgway, Paul Fen
dc.contributor.authorKeenan, Niamhen
dc.contributor.authorSweeney, Karl Jen
dc.contributor.authorBrophy, David Pen
dc.contributor.authorHill, Arnold D Ken
dc.contributor.authorEvoy, Denisen
dc.contributor.authorO'Higgins, Niall Jen
dc.contributor.authorMcDermott, Enda W Men
dc.date.accessioned2010-03-12T15:43:27Z-
dc.date.available2010-03-12T15:43:27Z-
dc.date.issued2009-06-
dc.identifier.citationDetected peritoneal fluid in small bowel obstruction is associated with the need for surgical intervention. 2009, 52 (3):201-6 Can J Surgen
dc.identifier.issn1488-2310-
dc.identifier.pmid19503664-
dc.identifier.urihttp://hdl.handle.net/10147/94219-
dc.description.abstractBACKGROUND: Predicting the clinical course in adhesional small bowel obstruction is difficult. There are no validated clinical or radiologic features that allow early identification of patients likely to require surgical intervention. METHODS: We conducted a retrospective review of 100 patients consecutively admitted to a tertiary level teaching hospital over a 3-year period (2002-2004) who had acute adhesional small bowel obstruction and underwent computed tomography (CT). The primary outcomes that we assessed were conservative management or the need for surgical intervention. We investigated time to physiologic gastrointestinal function recovery as a secondary outcome. We examined independent predictors of surgical intervention in a bivariate analysis using a stepwise logistic regression analysis. RESULTS: Of the 100 patients investigated, we excluded 12. Of the 88 remaining patients, 58 (66%) were managed conservatively and 30 (34%) underwent surgery. Peritoneal fluid detected on a CT scan (n = 37) was associated more frequently with surgery than conservative management (46% v. 29%, p = 0.046, chi(2)). Logistical regression identified peritoneal fluid detected on a CT scan as an independent predictor of surgical intervention (odds ratio 3.0, 95% confidence interval 1.15-7.84). CONCLUSION: The presence of peritoneal fluid on a CT scan in patients with adhesional small bowel obstruction is an independent predictor of surgical intervention and should alert the clinician that the patient is 3 times more likely to require surgery.-
dc.language.isoenen
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshAscitic Fluid-
dc.subject.meshCohort Studies-
dc.subject.meshFemale-
dc.subject.meshGastrointestinal Transit-
dc.subject.meshHumans-
dc.subject.meshIntestinal Obstruction-
dc.subject.meshIntestine, Small-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPredictive Value of Tests-
dc.subject.meshRecovery of Function-
dc.subject.meshRetrospective Studies-
dc.subject.meshTomography, X-Ray Computed-
dc.subject.meshTreatment Outcome-
dc.titleDetected peritoneal fluid in small bowel obstruction is associated with the need for surgical intervention.en
dc.contributor.departmentSurgical Professorial Unit, St Vincent'sUniversity Hospital, Elm Park, Dublin, Ireland.en
dc.identifier.journalCanadian journal of surgery. Journal canadien de chirurgieen

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