Determining the need for surgery in small bowel obstructions based on clinical, laboratory, and radiological parameters Determinación de la necesidad de cirugía en obstrucciones del intestino delgado según parámetros clínicos, de laboratorio y radiológicos


Mert A., Yurdakul-Deniz F.

Cirugia y Cirujanos (English Edition), cilt.92, sa.4, ss.487-494, 2024 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 92 Sayı: 4
  • Basım Tarihi: 2024
  • Doi Numarası: 10.24875/ciru.23000586
  • Dergi Adı: Cirugia y Cirujanos (English Edition)
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals
  • Sayfa Sayıları: ss.487-494
  • Anahtar Kelimeler: Conservative approach, Ileus, Small bowel obstruction, Surgical treatment
  • Bursa Uludağ Üniversitesi Adresli: Evet

Özet

Objective: Small bowel obstruction (SBO) is a common and important surgical emergency. Our aim in this study is to describe the clinical, laboratory, and computed tomography (CT) findings to facilitate the objective identification of SBO patients in need of operative treatment in this patient population. Methods: This retrospective study included 340 patients hospitalized due to a preliminary diagnosis of ileus. Retrieved data of patients included age, gender, comorbidities, previous hospitalization due to ileus, surgical history, physical examination findings, complete blood count and biochemistry test results, and CT findings at admission. Results: The study included 180 (52.9%) male and 160 (47.1%) female patients. Treatment was conservative in 216 patients and surgery in 124 patients. Of the patients included in the study, 36.4% needed surgery. Of the female patients, 38.90% received conservative treatment and 61.30% underwent surgery. Adhesions were the most common cause of obstruction in operated patients (43.50%). Conclusion: We have found that female gender, vomiting, guarding, rebound, C-reactive protein levels above 75 mg/L, increased bowel diameter, and a transition zone on CT images indicate a strong need for surgery, but a history of previous hospitalization for ileus may show that surgery may not be the best option.