Nonoperative management of patients with a diagnosis of high-grade small bowel obstruction by computed tomography

Flavio G. Rocha, Todd A. Theman, Evan Matros, Stephen M. Ledbetter, Michael J. Zinner, Stephen J. Ferzoco

Research output: Contribution to journalArticle

Abstract

Objective: To determine the natural history and treatment of high-grade small bowel obstruction (HGSBO). Small bowel obstruction is a frequent complication of abdominal surgery. Complete and strangulating obstructions are managed operatively while partial obstructions receive a trial of nonoperative therapy. The management and outcome of patients with HGSBO diagnosed by computed tomography (CT) has not been examined. Design: Retrospective medical record review. Outcomes for nonoperative vs operative management were analyzed using Fisher exact and log-rank tests. Setting: Tertiary care referral center. Patients: One thousand five hundred sixty-eight consecutive patients admitted from the emergency department with a diagnosis of small bowel obstruction between 2000 and 2005 by CT criteria. Main Outcome Measures: Recurrence of symptoms and complications. Results: One hundred forty-five patients (9%) with HGSBO were identified, with 88% follow-up (median, 332 days; range, 4-2067 days). Sixty-six (46%) were successfully managed nonoperatively while 79 (54%) required an operation. Length of stay and complications were significantly increased in the operative group (4.7 days vs 10.8 days and 3% vs 23%; P

Original languageEnglish (US)
Pages (from-to)1000-1004
Number of pages5
JournalArchives of Surgery
Volume144
Issue number11
DOIs
Publication statusPublished - Nov 2009
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery

Cite this

Rocha, F. G., Theman, T. A., Matros, E., Ledbetter, S. M., Zinner, M. J., & Ferzoco, S. J. (2009). Nonoperative management of patients with a diagnosis of high-grade small bowel obstruction by computed tomography. Archives of Surgery, 144(11), 1000-1004. https://doi.org/10.1001/archsurg.2009.183