Application of the AAST EGS Grade for Adhesive Small Bowel Obstruction to a Multi‐national Patient Population

Hernandez, Matthew C.; Birindelli, Arianna; Bruce, John; Buitendag, J J P; Kong, V Y; Beuran, Mircea; Aho, Johnathon M.; Negoi, Ionuț; Clarke, Damian; Saverio, Salomone Di; Zielinski, Martin D.

doi:10.1007/s00268-018-4671-1

Cited by 20 publications

(10 citation statements)

References 43 publications

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“…de 59 años, que concuerda con los estudios de Hernández et al 16 y Matsushima et al 17 , aunque otros estudios describen la mayoría de los casos en pacientes mayores de 65 años 18,19 .…”

Section: Discussionunclassified

Análisis clínico-tomográfico en obstrucción de intestino delgado por adherencias según el sitio de obstrucción en la tomografía

et al. 2021

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Introducción. Las adherencias postoperatorias son la causa más frecuente de obstrucción de intestino delgado. La clínica sugiere el diagnóstico, pero de manera poco precisa la causa y el sitio de la obstrucción. La tomografía computarizada contrastada es el estudio óptimo y permite identificar de manera oportuna a los pacientes que requieren intervención quirúrgica. El objetivo de este estudio fue analizar la correlación entre la clínica y el sitio de obstrucción detectado en la tomografía computarizada contrastada de abdomen, en pacientes con sospecha diagnóstica de obstrucción de intestino delgado por adherencias. Métodos. Estudio prospectivo, transversal y analítico de pacientes con sospecha clínica de obstrucción de intestino delgado por adherencias y antecedentes quirúrgicos y su correlación con el sitio de obstrucción detectado en la tomografía computarizada de abdomen contrastada, de pacientes atendidos entre marzo de 2016 y febrero de 2019 en un hospital de segundo nivel. Resultados. Se incluyeron 41 pacientes, la media de edad fue de 59 años y el género masculino el más comprometido (68,3 %, n=28); la ausencia de evacuaciones estuvo presente en 97,5 % (p=0,026). La tomografía computarizada contrastada mostró el sitio de obstrucción en 73 % de los pacientes y la localización de la obstrucción más prevalente fue en íleon distal (31,7 %, n=13). Se asoció a leucocitosis (p=0,041) y a dolor más intenso (p=0,049), sin presentar irritación peritoneal. Conclusión. La obstrucción localizada en el íleon distal se caracterizó por presentar más dolor y mayor recuento leucocitario, sin correlación como factor de riesgo para requerir tratamiento quirúrgico.

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Section: Discussionunclassified

Análisis clínico-tomográfico en obstrucción de intestino delgado por adherencias según el sitio de obstrucción en la tomografía

et al. 2021

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“…An NSQIP study that included a subset of patients with all‐cause SBO at 13 voluntary USA and Canadian institutions reported lower unadjusted mortality rates of 3·3 per cent in operated patients and 4·5 per cent in the non‐operative group. Another recent multinational retrospective study limited to four centres reported a mortality rate of just 2 per cent across both operated and non‐operated patients with adhesive SBO; however, the primary objective of that study was retrospective validation of a proposed risk prediction tool and it may have been subject to selection bias. Both studies had non‐surgery rates exceeding 60 per cent.…”

Section: Discussionmentioning

confidence: 99%

National prospective cohort study of the burden of acute small bowel obstruction

et al. 2019

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Background Small bowel obstruction is a common surgical emergency, and is associated with high levels of morbidity and mortality across the world. The literature provides little information on the conservatively managed group. The aim of this study was to describe the burden of small bowel obstruction in the UK. Methods This prospective cohort study was conducted in 131 acute hospitals in the UK between January and April 2017, delivered by trainee research collaboratives. Adult patients with a diagnosis of mechanical small bowel obstruction were included. The primary outcome was in‐hospital mortality. Secondary outcomes included complications, unplanned intensive care admission and readmission within 30 days of discharge. Practice measures, including use of radiological investigations, water soluble contrast, operative and nutritional interventions, were collected. Results Of 2341 patients identified, 693 (29·6 per cent) underwent immediate surgery (within 24 h of admission), 500 (21·4 per cent) had delayed surgery after initial conservative management, and 1148 (49·0 per cent) were managed non‐operatively. The mortality rate was 6·6 per cent (6·4 per cent for non‐operative management, 6·8 per cent for immediate surgery, 6·8 per cent for delayed surgery; P = 0·911). The major complication rate was 14·4 per cent overall, affecting 19·0 per cent in the immediate surgery, 23·6 per cent in the delayed surgery and 7·7 per cent in the non‐operative management groups ( P < 0·001). Cox regression found hernia or malignant aetiology and malnutrition to be associated with higher rates of death. Malignant aetiology, operative intervention, acute kidney injury and malnutrition were associated with increased risk of major complication. Conclusion Small bowel obstruction represents a significant healthcare burden. Patient‐level factors such as timing of surgery, acute kidney injury and nutritional status are factors that might be modified to improve outcomes.

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“…Bowel obstruction is a common cause of hospitalization and among the most common indications for surgery in the United States but is a rare cause of ICU admission. 20 Mechanical obstruction of the small bowel is typically caused by extrinsic compression. In the United States, the most common cause is intra-abdominal adhesions from prior surgery while worldwide the most common etiology of small bowel obstruction is incarcerated hernia.…”

Section: Intestinal Obstructionmentioning

confidence: 99%

“…Bowel obstruction is a common cause of hospitalization and among the most common indications for surgery in the United States but is a rare cause of ICU admission 20. Mechanical obstruction of the small bowel is typically caused by extrinsic compression.…”

Section: Gastroenterological Surgical Emergenciesmentioning

confidence: 99%

Surgical Emergencies in the ICU

Saini

Ashraf

Babowice

et al. 2023

Critical Care Nursing Quarterly

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Surgical emergencies are common in the critical care setting and require prompt diagnosis and management. Here, we discuss some of the surgical emergencies involving the gastrointestinal, hepatobiliary, and genitourinary sites. In addition, foreign body aspiration and necrotizing soft-tissue infections have been elaborated. Clinicians should be aware of the risk factors, keys examination findings, diagnostic modalities, and medical as well as surgical treatment options for these potentially fatal illnesses.

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Application of the AAST EGS Grade for Adhesive Small Bowel Obstruction to a Multi‐national Patient Population

Abstract: Study type Retrospective multi-institutional cohort study.

Cited by 20 publications

References 43 publications

Análisis clínico-tomográfico en obstrucción de intestino delgado por adherencias según el sitio de obstrucción en la tomografía

Análisis clínico-tomográfico en obstrucción de intestino delgado por adherencias según el sitio de obstrucción en la tomografía

National prospective cohort study of the burden of acute small bowel obstruction

Surgical Emergencies in the ICU

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