Ann Surg Treat Res.  2018 Feb;94(2):94-101. 10.4174/astr.2018.94.2.94.

Early postoperative small bowel obstruction after laparotomy for trauma: incidence and risk factors

• Kang WS
• Park YC
• Jo YG
• Kim JC

• KMID: 2402852
• DOI: http://doi.org/10.4174/astr.2018.94.2.94

Abstract

PURPOSE
This study aimed to investigate the incidence and risk factors of early postoperative small bowel obstruction (EPSBO) after laparotomy for trauma patients.
METHODS
From 2009 to 2016, consecutive patients who had undergone laparotomy for trauma were retrospectively evaluated. EPSBO was defined as the presence of signs and symptoms of obstruction between postoperative days 7 and 30, or obstruction occurring anytime within 30 days and lasting more 7 days.
RESULTS
Among 297 patients who met the inclusion criteria, 72 (24.2%) developed EPSBO. The length of hospital stay was significantly longer in patients with EPSBO than in those without EPSBO (median [interquartile range], 34 [21-48] days 24 [14-38] days, P < 0.001). Multivariate logistic analysis identified male sex (adjusted odds ratio [AOR], 3.026; P = 0.008), intraoperative crystalloid (AOR, 1.130; P = 0.031), and Abbreviated Injury Scale (AIS) score for mesenteric injury (AOR, 1.397; P < 0.001) as independent risk factors for EPSBO. The incidence of adhesive small bowel adhesion after 30 days postoperatively did not significantly differ between the 2 groups (with EPSBO, 5.6% without EPSBO, 5.3%; P = 0.571). Most of the patients with EPSBO were recovered by conservative treatment (95.8%).
CONCLUSION
After laparotomy for trauma patients, the incidence of EPSBO was 24.2% in our study. EPSBO was associated with a longer hospital stay. Male sex, use of intraoperative crystalloid, and AIS score for mesenteric injury were significant independent risk factors for EPSBO. Patients with these risk factors should be followed-up more carefully.

Keyword

Laparotomy; Ileus; Abdominal injuries

MeSH Terms

Abbreviated Injury Scale
Abdominal Injuries
Adhesives
Humans
Ileus
Incidence*
Laparotomy*
Length of Stay
Male
Odds Ratio
Retrospective Studies
Risk Factors*
Adhesives

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