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Detected peritoneal fluid in small bowel obstruction is associated with the need for surgical intervention.
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
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
Advisors
Editors
Other Contributors
Date
2009-06
Date Submitted
Keywords
Other Subjects
Subject 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
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
Planned Date
Start Date
Collaborators
Principal Investigators
Files
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19503664.pdf
Adobe PDF, 193.6 KB
Alternative Titles
Publisher
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
ISSN
1488-2310
eISSN
ISBN
DOI
PMID
19503664