Aim: To study and identify early clinical and radiological findings that could help to predict operative intervention for small bowel obstruction.
Materials and methods: One hundred and nine consecutive patients with small bowel obstruction who underwent small bowel follow-through examination with Gastrografin(®) during 2005-2006. The patients were divided into an operative group and a non-operative group, n = 44 and 65, respectively. Findings primarily noted were those which were possible to register within 1-4 h from hospital arrival.
Results: In univariate analyses, factors found to be significantly associated with surgical intervention were no prior abdominal surgery, the presence of radiological differential air fluid levels, and absence of flatulence 24 h prior to admission, CRP > 10 mg/L and dehydration at admission. In multivariate analyses, the presence of dehydration and radiological differentiated air fluid levels were independent predictive factors of significance. Absence of all factors significantly favored non-operative treatment, while operative treatment was significantly favored when two or more factors were present.
Conclusions: The presence of two or more early predictive factors as defined above, available at admission, significantly correlates with a likelihood of complete obstruction and the need of surgical intervention.
Keywords: Differentiated air fluid levels; Predictive value; Small bowel follow-through; Small bowel obstruction.