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

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    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.
    Issue Date
    2009-06
    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
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    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
    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
    ISSN
    1488-2310
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