Detected peritoneal fluid in small bowel obstruction is associated with the need for surgical intervention.
Authors
O'Daly, Brendan JRidgway, 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.Issue Date
2009-06MeSH
AgedAged, 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
Metadata
Show full item recordCitation
Detected peritoneal fluid in small bowel obstruction is associated with the need for surgical intervention. 2009, 52 (3):201-6 Can J SurgJournal
Canadian journal of surgery. Journal canadien de chirurgiePubMed ID
19503664Abstract
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
enISSN
1488-2310Collections
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