Mechanical Small Bowel Obstruction

Playforth, R H; Holloway, James B.; Griffen, Ward O.

doi:10.1097/00000658-197005000-00018

Cited by 67 publications

(14 citation statements)

References 6 publications

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“…7,12,13,15,20 Our study found no difference between the two groups in type of surgery required and in time to surgery with average times similar to recently published overall population data. 15 Therefore, delay to surgical treatment is an unlikely cause of any increase in geriatric morbidity or mortality.…”

Section: Discussionsupporting

confidence: 89%

“…The overall operative mortality was 3.4%, which is on the lower end of the range reported in other recent studies. 2,3,7,12,13,26 The geriatric patients in our study had an increased mortality relative to the younger cohort, however this was not statistically significant likely due to an underpowered study. Surgical mortality for abdominal surgery in the elderly has been shown to be due a number of factors including increased number of comorbid diseases, malignant disease, and severity of surgical condition.…”

Section: Discussionmentioning

confidence: 54%

“…There is a motto among surgeons of historic nature that “The sun should never rise or set on a small bowel obstruction.” 13,20 However, that tactic has softened over the past twenty years, and now the current approach relies on medical management for most patients. The modern strategy involves evaluating for completeness of the obstruction and to identifying patients with an urgent need for surgery, such as those with bowel compromise, hernia incarceration, sepsis, or peritonitis.…”

Section: Discussionmentioning

confidence: 99%

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Geriatric small bowel obstruction: an analysis of treatment and outcomes compared with a younger cohort

Krause

Webb

2015

The American Journal of Surgery

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Background Small bowel obstruction (SBO) is a common condition, but little is known about its presentation, management, and outcomes in geriatric patients. Methods A retrospective review was performed comparing geriatric (≥65 years of age) and non-geriatric patients admitted with SBO. Admission characteristics, treatment, and outcomes were compared. Data analysis included Student’s t test and chi-square test or Fisher exact test. Results Among 80 geriatric and 136 non-geriatric patients no difference was observed between admission characteristics, treatment, time to or type of surgery, length of post-op stay, or overall complications. Cardiac complications (15% vs 0%, p=0.0082) and sub-acute care facility discharge (29% vs 5%, p<0.001) were more common for geriatric patients. Conclusions Compared to younger adults, elderly patients with SBO have similar presentations and overall outcomes with the exception of cardiac morbidity and discharge disposition. Pre-operative attention to cardiac risk profile and discharge disposition discussion should be encouraged. Summary This study analyzes geriatric patients presenting with small bowel obstruction when cared for by an Acute Care Surgery service. Compared to younger adults, the presentation, treatment response, and outcomes are similar with the exception of cardiac complications and discharge destination.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

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Geriatric small bowel obstruction: an analysis of treatment and outcomes compared with a younger cohort

Krause

Webb

2015

The American Journal of Surgery

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“…Patient-related factors such as age, concomitant disease, necrosis of the bowels and delayed therapy were associated with mortality in previous studies (9)(10)(11)(12). Fevank et al (13) reported age to be the most significant factor in terms of death and complications.…”

Section: Discussionmentioning

confidence: 93%

“…Table 4. Risk factor analysis in terms of mortality Playfort et al (10) pointed out the adverse effects of therapeutic delay in patients with mechanical bowel obstruction, and reported that the increase in time intervals from onset of symptoms to hospitalization, and in-hospital delay prior to surgery led to an increase in the rate of complications and death. It has been stated that therapeutic delay of over 24 h tripled the mortality risk (13).…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Morbidity and Mortality in Patients with Mechanical Bowel Obstruction

Halis¹,

Söğüt

Güloğlu

et al. 2012

JAEM

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IntroductionAcute mechanical bowel obstruction is a common condition among surgical emergencies. It has high morbidity and creates a major burden financially due to its recurrent nature. Natural progression and risk factors of bowel obstruction have not been clearly defined, and the surgical approach to be adopted, timing of the intervention and procedures for preventing relapses are still issues that are being debated (1). The causes and therapeutic approaches of bowel obstruction vary (2). Previous studies carried out in different parts of Turkey reported that, although an increase was observed in the incidence of post-surgical adhesion related bowel obstruction in socioeconomically developed regions, incarcerated hernia was still the leading cause of bowel obstruction (3-6). Development of effective medical and surgical therapeutic approaches, combined with better diagnostic tests, have contributed significantly to the decrease in the incidence of complications and mortality and morbidity rates in patients with bowel obstruction (7,8). The purpose of the present Abstract Objective: The aim of this study was to investigate the factors affecting morbidity and mortality by evaluating the demographical, etiological and clinical characteristics of patients with mechanical bowel obstruction. Materials and Methods: Data for 171 mechanical bowel obstruction patients were evaluated retrospectively. The patients were assessed in mortality (n=21), morbidity (n=55) and recovery (n=95) groups. Results: Of the patients, 70% were men; and 27.4% were ≥55 years of age. While gender had no impact on mortality and morbidity, age did. Adhesion was observed to be the leading cause (45.6%) of mechanical bowel obstruction, followed by incarcerated hernia in 17.5%. Intestinal necrosis was associated with mortality but not with morbidity. Late presentation and multiple concomitant diseases had no impact on mortality but were associated with morbidity. The presence of a concomitant disease and leukocytosis or leukopenia had a significant impact on both mortality and morbidity. Conclusion: Older age and presence of a concomitant disease, leukocytosis or leukopenia were established to be associated with mortality and morbidity. Late presentation and multiple concomitant diseases were associated only with morbidity. The presence of intestinal necrosis was associated only with mortality. Establishing the risk factors well will be beneficial in lowering the incidences of morbidity and mortality. (JAEM 2012; 11: 1-5) Özet Amaç: Mekanik barsak tıkanıklığı tanısı konulmuş hastalarda demografik, etiyolojik ve klinik özellikler değerlendirilerek morbidite ve mortaliteyi etkileyen faktörlerin araştırılması amaçlandı. Gereç ve Yöntemler: Mekanik barsak tıkanıklığı tanısı alan 171 hastanın bilgileri retrospektif olarak değerlendirildi. Hastalar; mortalite grubu (n=21), morbidite grubu (n=55) ve şifa grubuna (n=95) ayrılarak değerlendirildi. Bulgular: Hastaların %70'i erkek olup, %27.4'ü ≥55 yaş idi. Cinsiyetin mortalite ve morbiditeye etkisi anla...

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