Clinical Factors Associated with Intestinal Strangulating Obstruction and Recurrence in Adhesive Small Bowel Obstruction, MOHAMED IBRAHIM SHALAMESH
Abstract
Background: Post-operative adhesions are a mutualreason of small-bowel obstructions, and up to 53 percent of cases operated on for adhesive small-bowel obstructions (ASBO) face recurrences. Our study evaluated the clinical parameters accompanied with strangulating obstructions and the risk factors with ASBO rate of recurrence. Patients and Methods: A retrospective research has been carried out by the department data-base. 80 Patients with ASBO were included in the study and followed-up from January 2016 to July 2018 at Sayed Galal University Hospital. The clinical issues a companied with strangulation of obstruc-tions and recurrences after ward treating were assessed. Results: Of the 80 involved ASBO cases, the obstructions recurred in 22 patients with a rate of recurrence was 27.5% (22/288), and 6 of those 22-patients experienced repeated surgical operation [rate of re-operation 27.3% (6/22)], whereas the other 16 cases underwent conservation treatment. The rate of recurrent of the simple ASBO group was 28.6% (19/72), and the median non-recurrence period was 12.2-mths. The rate of recurrence of the strangulating obstructing group was 37.5% (3/8), and the median non-recurrence period was 11.5- mths. The alterations among the studied groups were consid-ered as non-significant (p-value=0.241). Conclusion: Four clinical factors involving leukocytosis, tachycardia, together with CT results of thickening or swelling of the mesentery and CT displaying seroperitoneum, a com-panying with incidence of intestinal strangulations in ASBO. ASBO-cases who experienced operative intervention had a decreased rate of recurrence, but ASBO-cases with strangu-lating obstructions hadn'trise therate of recurrence in compar-ison to those of cases with simple ASBO.