Ann Surg Treat Res.  2015 Jun;88(6):325-333. 10.4174/astr.2015.88.6.325.

Surgical indicators for the operative treatment of acute mechanical intestinal obstruction due to adhesions

• Eren T
• Boluk S
• Bayraktar
• Ozemir IA
• Yildirim Boluk S
• Tombalak E
• Alimoglu O

• KMID: 1800646
• DOI: http://doi.org/10.4174/astr.2015.88.6.325

Abstract

PURPOSE
Our aim was to investigate the predictive factors indicating strangulation, and the requirement for surgery in patients with acute mechanical intestinal obstruction due to adhesions.
METHODS
This study retrospectively evaluated the records of patients with adhesive acute mechanical intestinal obstruction. The surgical treatment (group S), conservative treatment (group C), intraoperative bowel ischemia (group I), and intraoperative adhesion only (group A) groups were statistically evaluated according to the diagnostic and surgical parameters.
RESULTS
The study group of 252 patients consisted of 113 women (44.8%), and 139 men (55.2%). The mean age was 62.79 +/- 18.08 years (range, 20-98 years). Group S consisted of 50 patients (19.8%), and 202 (80.2%) were in group C. Group I consisted of 19 patients (38%), where as 31 (62%) were in group A. In group S, the prehospital symptomatic period was longer, incidence of fever was increased, and elevated CRP levels were significant (P < 0.05). Plain abdominal radiography, and abdominal computerized tomography were significantly sensitive for strangulation (P < 0.05). The elderly were more prone to strangulation (P < 0.05). Fever, rebound tendernes, and urea & creatinine levels were significantly higher in the presence of strangulation (P < 0.05, P < 0.05, and P < 0.05, consecutively).
CONCLUSION
Fever, rebound tenderness, urea & creatinine levels, plain abdominal radiography, and abdominal computerized tomography images were important indicators of bowel ischemia. Longer prehospital symptomatic period was related with a tendency for surgical treatment, and the elderly were more prone to strangulation. CRP detection was considered to be useful for the decision of surgery, but not significantly predictive for strangulation.

Keyword

Intestinal obstruction; Surgery; Tissue adhesions

MeSH Terms

Adhesives
Aged
Creatinine
Female
Fever
Humans
Incidence
Intestinal Obstruction*
Ischemia
Male
Radiography, Abdominal
Retrospective Studies
Tissue Adhesions
Urea
Adhesives
Creatinine
Urea

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