Article

Predictive factors for surgical indication in adhesive small bowel obstruction.

Department of Surgery, Ishikiriseiki Hospital, 18-28 Yayoicho, Higashiosaka 579-8026, Osaka, Japan.
American journal of surgery (impact factor: 2.36). 07/2008; 196(1):23-7. DOI:10.1016/j.amjsurg.2007.05.048 pp.23-7
Source: PubMed

ABSTRACT Small bowel obstruction (SBO) after abdominal surgery is usually treated successfully with intestinal decompression using a long nasointestinal tube (LT), but some cases fail to respond.
Clinical background and laboratory data on admission were evaluated retrospectively for 53 patients with adhesive SBO to determine predictive factors for failure of LT decompression, and the appropriate timing of laparotomy was investigated.
Complete SBO (no evidence of air within the large bowel) and increased serum creatine phosphokinase (>or=130 IU/L) were independent predictive factors for LT decompression failure. Laparotomy was indicated in 14 patients (9 and 5 with complete and partial SBO, respectively), whereas successful LT decompression occurred in 39 patients (9 and 30, respectively). Resolution of SBO took significantly longer for complete SBO (6.3 days) than for partial SBO (2.6 days).
Patients with complete SBO or high serum creatine phosphokinase (CPK) may not respond to LT decompression. Laparotomy is appropriate after non-response for 7 and 3 days for complete and partial SBO, respectively.

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Keywords

3 days
 
39 patients
 
53 patients
 
abdominal surgery
 
adhesive SBO
 
appropriate timing
 
cases
 
complete
 
complete SBO
 
CPK
 
intestinal decompression
 
laboratory data
 
Laparotomy
 
LT decompression
 
LT decompression failure
 
nasointestinal tube
 
partial SBO
 
predictive factors
 
Small bowel obstruction
 
successful LT decompression
 

Shogo Tanaka