Postoperative adhesive small bowel obstruction: the resources impacts

To assess the resource implications of managing small bowel obstruction, which is common and has diverse causes and outcomes.

A retrospective study of 332 patients documented to have postoperative, adhesive small bowel obstruction, from 1988 to 1996, was carried out. Complications and resources used were recorded and costs were determined. Results. There were 207 females and 125 males, with a median age of 63 years. There were 374 hospital admissions, in 121 (32.4%) of which no surgical operation was performed. Patients had a median hospital stay of eight days. The overall median cost for a patient who had no operation was NZ$1 039 (minimum $94, maximum $13 262), compared to NZ$7 630 (minimum $2 038, maximum $135 173) for a patient who had an operation. Postoperative adhesive small bowel obstruction accounted for 1.3% of all admissions, 59.2% of all cases of bowel obstruction, 65.2% of all admissions with small bowel conditions, 73.5% of laparotomies for bowel obstruction and 4.1% of all laparotomies. Sixty-eight patients (20.5%) developed a total of 102 complications and there were eight deaths (2.4%).

Postoperative adhesive small bowel obstruction is a common condition, which is associated with a substantial morbidity and workload. The treatment of these conditions has significant health care costs. Most are emergencies and the costs of their management are very variable.