Clinicoradiological score for predicting the risk of strangulated small bowel obstruction

The British Journal of Surgery
F SchwenterP Gervaz

Abstract

Intestinal ischaemia as a result of small bowel obstruction (SBO) requires prompt recognition and early intervention. A clinicoradiological score was sought to predict the risk of ischaemia in patients with SBO. A clinico-radiological protocol for the assessment of patients presenting with SBO was used. A logistic regression model was applied to identify determinant variables and construct a clinical score that would predict ischaemia requiring resection. Of 233 consecutive patients with SBO, 138 required laparotomy of whom 45 underwent intestinal resection. In multivariable analysis, six variables correlated with small bowel resection and were given one point each towards the clinical score: history of pain lasting 4 days or more, guarding, C-reactive protein level at least 75 mg/l, leucocyte count 10 x 10(9)/l or greater, free intraperitoneal fluid volume at least 500 ml on computed tomography (CT) and reduction of CT small bowel wall contrast enhancement. The risk of intestinal ischaemia was 6 per cent in patients with a score of 1 or less, whereas 21 of 29 patients with a score of 3 or more underwent small bowel resection. A positive score of 3 or more had a sensitivity of 67.7 per cent and specificity 90.8 per cent; the ar...Continue Reading

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Citations

Jan 11, 2014·La Radiologia medica·Daniela BerrittoRoberto Grassi
Aug 26, 2014·World Journal of Surgery·Raphael P H MeierFrank Schwenter
Dec 8, 2011·Minimally Invasive Therapy & Allied Technologies : MITAT : Official Journal of the Society for Minimally Invasive Therapy·Nicolas C BuchsPhilippe Morel
Oct 26, 2016·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Kazuhide MatsushimaDemetrios Demetriades
Aug 5, 2017·Langenbeck's Archives of Surgery·Anna WeissMarco Tomassi
Jun 2, 2015·Annals of Surgical Treatment and Research·Tunc ErenOrhan Alimoglu
Nov 30, 2018·The Journal of Trauma and Acute Care Surgery·Kazuhide MatsushimaDemetrios Demetriades
Jan 12, 2019·The Journal of Trauma and Acute Care Surgery·Lyndsey E WesselsMichael J Sise
Dec 27, 2012·The Journal of Trauma and Acute Care Surgery·Adrian A MaungUNKNOWN Eastern Association for the Surgery of Trauma
Jan 12, 2020·World Journal of Surgery·Mahdi BouassidaHassen Touinsi
Feb 15, 2020·Annals of Coloproctology·Young Jae ChoKi Hwan Kim
Mar 26, 2019·The Journal of Trauma and Acute Care Surgery·Lyndsey E WesselsMichael J Sise
Apr 26, 2014·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Francesca IacobellisRoberto Grassi
May 22, 2018·Gastroenterology Research and Practice·Xiaming HuangLei Zhuang
May 15, 2018·ANZ Journal of Surgery·Jakob Köstenbauer, Philip G Truskett
Aug 19, 2017·Deutsches Ärzteblatt International·Tim O VilzJörg C Kalff
Mar 17, 2021·Asian Journal of Endoscopic Surgery·Shunsuke HayakawaShuji Takiguchi

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