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Isaksson K, Weber E, Andersson R, et al. Small bowel obstruction: early parameters predicting the need for surgical intervention. Eur J Trauma Emerg Surg. 2010;37(2):155-9doi: 10.1007/s00068-010-0033-x.
Isaksson, K., Weber, E., Andersson, R., & Tingstedt, B. (2011). Small bowel obstruction: early parameters predicting the need for surgical intervention. European journal of trauma and emergency surgery : official publication of the European Trauma Society, 37(2), 155-9. https://doi.org/10.1007/s00068-010-0033-x
Isaksson, K, et al. "Small bowel obstruction: early parameters predicting the need for surgical intervention." European journal of trauma and emergency surgery : official publication of the European Trauma Society vol. 37,2 (2011): 155-9. doi: https://doi.org/10.1007/s00068-010-0033-x
Isaksson K, Weber E, Andersson R, Tingstedt B. Small bowel obstruction: early parameters predicting the need for surgical intervention. Eur J Trauma Emerg Surg. 2011 Apr;37(2):155-9. doi: 10.1007/s00068-010-0033-x. Epub 2010 Jul 08. PMID: 26814954.
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Eur J Trauma Emerg Surg. 2011 Apr;37(2):155-9. doi: 10.1007/s00068-010-0033-x. Epub 2010 Jul 08.

Small bowel obstruction: early parameters predicting the need for surgical intervention.

European journal of trauma and emergency surgery : official publication of the European Trauma Society

K Isaksson, E Weber, R Andersson, B Tingstedt

Affiliations

  1. Department of Surgery, University of Lund, University Hospital of Lund, 221 85, Lund, Sweden. [email protected].
  2. Department of Surgery, University of Lund, University Hospital of Lund, 221 85, Lund, Sweden.

PMID: 26814954 DOI: 10.1007/s00068-010-0033-x

Abstract

AIM: To study and identify early clinical and radiological findings that could help to predict operative intervention for small bowel obstruction.

MATERIALS AND METHODS: One hundred and nine consecutive patients with small bowel obstruction who underwent small bowel follow-through examination with Gastrografin(®) during 2005-2006. The patients were divided into an operative group and a non-operative group, n = 44 and 65, respectively. Findings primarily noted were those which were possible to register within 1-4 h from hospital arrival.

RESULTS: In univariate analyses, factors found to be significantly associated with surgical intervention were no prior abdominal surgery, the presence of radiological differential air fluid levels, and absence of flatulence 24 h prior to admission, CRP > 10 mg/L and dehydration at admission. In multivariate analyses, the presence of dehydration and radiological differentiated air fluid levels were independent predictive factors of significance. Absence of all factors significantly favored non-operative treatment, while operative treatment was significantly favored when two or more factors were present.

CONCLUSIONS: The presence of two or more early predictive factors as defined above, available at admission, significantly correlates with a likelihood of complete obstruction and the need of surgical intervention.

Keywords: Differentiated air fluid levels; Predictive value; Small bowel follow-through; Small bowel obstruction

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