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A Study of the Prediction of Bowel Resection due to Strangulated Small Bowel Obstruction [post]

Tetsunobu Udaka, Atsuki Taniguchi, Jun Kouzai, Tomoaki Ootsuka, Nobuyuki Watanabe, Izuru Endou, Osamu Yoshida, Hiroaki Asano, Masatoshi Kubo
2020 unpublished
Background: In this retrospective study, we aimed to assess the predictive factors for bowel resection due to strangulated small bowel obstruction (SSBO). Methods: We enrolled a total of 109 patients diagnosed with SSBO at surgery. They were divided into two groups: those who underwent bowel resection and those who did not. The clinical findings, blood test results, blood gas analysis results, computed tomography (CT) findings, and sequential organ failure assessment (SOFA) scores of the
more » ... cores of the patients were examined and compared between the two groups. Results: A univariate analysis indicated significant predictive factors to be a history of abdominal surgery, prolonged time from the onset of disease to the operation, increased C-reactive protein (CRP) level, decreased albumin, SOFA score, existence of closed-loop obstruction, and reduced enhancement of the intestinal wall at CT. A multivariate analysis indicated that a reduced enhancement of the intestinal wall and the existence of closed-loop obstruction were independent predictive factors. Strangulated bowel obstruction can progress to a serious condition. It is therefore crucial to predict preoperatively those patients who are likely to require bowel resection. Conclusions: Assessing the reduced enhancement of the intestinal wall and the existence of closed-loop obstruction are required in order to determine whether or not resection of the incarcerated intestine with SSBO is necessary. Key words: strangulated small bowel obstruction, prognostic factor, bowel resection, reduced enhancement of the intestinal wall, closed-loop obstruction
doi:10.21203/ fatcat:76azicq67fcgziednvboflxbzq