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Related Experiment Videos

Operative acute small bowel obstruction: admitting service impacts outcome.

D P Schwab1, D W Blackhurst, R P Sticca

  • 1Department of Surgical Education, Division of Academic Services, Greenville Hospital System, South Carolina 29605, USA.

The American Surgeon
|December 4, 2001
PubMed
Summary

Early surgical evaluation for acute small bowel obstruction (SBO) is crucial. Delays in diagnosis and treatment, particularly when admitted to a medical service, significantly increase patient morbidity and mortality.

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Area of Science:

  • Surgery
  • Gastroenterology
  • Clinical Outcomes

Background:

  • Early surgical intervention in acute small bowel obstruction (SBO) is vital for reducing patient morbidity and mortality.
  • Factors influencing delayed intervention and patient outcomes in SBO require further analysis.

Purpose of the Study:

  • To analyze factors associated with surgically managed acute SBO, focusing on delays in intervention and their impact on patient outcomes.
  • To identify characteristics that correlate with increased morbidity and mortality in SBO cases.

Main Methods:

  • A retrospective review of 65 patients diagnosed with acute SBO between July 1997 and June 2000.
  • Data collected included patient demographics, admission details, comorbidities, diagnostic studies, surgical intervention timing, operative findings, and postoperative outcomes.

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  • Statistical analysis compared outcomes based on admitting service, length of stay, and need for small bowel resection.

    • Main Results:

    • Patients admitted to the surgical service had significantly better outcomes than those admitted to the medical service.
    • Admission to the medical service was linked to longer delays in surgery, increased length of stay, and higher rates of morbidity and mortality (27% vs. 2%).
    • No significant differences in morbidity and mortality were found based on the need for small bowel resection, patient age, obstruction etiology, or comorbidities.

    Conclusions:

    • Admission to a medical service is a primary cause of delayed treatment for SBO, leading to significantly higher mortality.
    • Early surgical evaluation is recommended for all patients presenting with suspected SBO to improve outcomes.