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Clinical studies of strangulating small bowel obstruction
Kunio Takeuchi1, Yasushi Tsuzuki, Tetsu Ando
1Department of Surgery, Tone Chuo Hospital, Numata-city, Gunma, Japan.
The American Surgeon
|February 18, 2004
Summary
Diagnosing intestinal necrosis in strangulating small bowel obstruction (SSBO) is challenging. Systemic inflammatory response syndrome (SIRS) and metabolic acidosis are key indicators of gangrenous intestine in SSBO patients.
Area of Science:
- Surgical Gastroenterology
- Clinical Diagnostics
- Biomarkers
Background:
- Preoperative diagnosis of intestinal necrosis in strangulating small bowel obstruction (SSBO) remains a clinical challenge.
- No definitive biomarkers currently exist for identifying gangrenous bowel in SSBO.
Purpose of the Study:
- To retrospectively analyze clinical symptoms and hematobiochemical data in SSBO patients.
- To identify reliable indicators for the presence of gangrenous intestine in SSBO.
Main Methods:
- Retrospective analysis of 37 SSBO patients, divided into groups with and without gangrenous intestine.
- Statistical analysis including chi-squared test, t-tests, simple regression, and stepwise logistic regression.
- Evaluation of clinical signs (peritoneal signs, shock) and laboratory data (WBC, SIRS, base deficit).
Main Results:
- Peritoneal signs, white blood cell count, systemic inflammatory response syndrome (SIRS), shock, and base deficit were significantly associated with intestinal gangrene.
- Base deficit showed a significant correlation with the length of gangrenous intestine.
- SIRS was identified as an independent predictor for the presence of gangrenous intestine.
Conclusions:
- Systemic inflammatory response syndrome (SIRS) and metabolic acidosis are strong indicators of gangrenous intestine in SSBO.
- These findings can aid in the preoperative diagnosis and management of SSBO patients.
- Early identification of gangrene can potentially improve patient outcomes.