CT Predictive Factors for Surgery Need in Patients with Small Bowel Obstruction
DOI:
https://doi.org/10.53903/01212095.85Keywords:
Bowel obstruction, Small intestine, Tomography, X-Ray computedAbstract
Background: The obstruction of the small intestine is one of the main causes of acute abdomen. Surgical management is usually reserved in cases that do not respond to conservative treatment; however, this can lead to a higher complication rate. Objective: To identify the findings in computed tomography of the abdomen that predict the need for surgical intervention in patients with small bowel obstruction at Hospital Universitario Nacional de Colombia between May 1, 2016 and May 30, 2018. Methodology: A retrospective, analytical, observational, cohort type study was conducted. 55 patients with small bowel obstruction were included. We performed a descriptive analysis and a logistic regression. The Odds Ratio (OR), sensitivity and specificity of tomography findings were estimated to predict the need for surgery. Results: A total of 55 patients were included, 22 (40%) which were women. The average age was 51.75 +/- 17.8 years. The median of past surgeries was significantly higher in women (women 2, men 1, p = 0.009). The most frequent symptoms were abdominal pain (100%), vomiting (85.5%) and other symptoms that showed frequency below 40%. Surgery was performed in 52.7% of patients. Among the tomographic findings, mesenteric edema showed association with the need for surgery (OR 5,13 CI95% 1,41–18,66), with a specificity of 84,6% and sensitivity of 48,3%. Conclusion: In tomography, mesenteric edema predicts the need for surgery in patients with small bowel obstruction with good specificity and low sensitivity.
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