Thrombocytopenia after emergency surgery for strangulated bowel obstruction

We investigated changes in platelet count after surgery for strangulated bowel obstruction (SBO), evaluated associations between postoperative thrombocytopenia and short-term outcomes, and identified risk factors for postoperative thrombocytopenia. This study included 109 patients who underwent emergency surgery for SBO between January 2014 and December 2023. Postoperative short-term outcomes were compared among three groups according to the lowest postoperative platelet count. Logistic regression analysis was used to identify risk factors associated with severe thrombocytopenia. All patients had platelet counts below the preoperative level within 72 h post-surgery. The severe thrombocytopenia (postoperative platelet count < 10 × 10⁴/µL) group exhibited significantly increased postoperative complications, 28-day mortality, and length of hospital stay. Preoperative thrombocytopenia, Sequential Organ Failure Assessment score, and bowel resection were independent risk factors for severe thrombocytopenia. Postoperative platelet counts fell below preoperative levels in all patients with SBO. Severe thrombocytopenia was associated with poor postoperative outcomes.