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dc.contributor.authorO'Daly, Brendan J
dc.contributor.authorRidgway, Paul F
dc.contributor.authorKeenan, Niamh
dc.contributor.authorSweeney, Karl J
dc.contributor.authorBrophy, David P
dc.contributor.authorHill, Arnold D K
dc.contributor.authorEvoy, Denis
dc.contributor.authorO'Higgins, Niall J
dc.contributor.authorMcDermott, Enda W M
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
refterms.dateFOA2018-08-31T05:00:23Z
html.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.


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