Predictor of early post-operative small bowel obstruction in patients undergoing emergency laparotomy and the role of computed tomography in detecting need for re-laparotomy
DOI:
https://doi.org/10.18203/2349-2902.isj20184082Keywords:
Early post-operative small bowel obstruction (EP-SBO), Laparotomy, PeritonitisAbstract
Background: Early Post-Operative Small Bowel Obstruction (EP-SBO) is common complication following laparotomy. Pathophysiology of early post-operative small bowel obstruction is poorly understood.
Methods: This cross-sectional observational study was conducted over a period of 18 month on 180 patients who underwent emergency abdominal laparotomy.
Results: EP-SBO developed in 35.55% patients. History of previous surgery, location of disease, degree of peritonitis, operative procedure, wound dehiscence was found to be significantly related with occurrence of EP-SBO.
Conclusions: EP-SBO is more likely to develop if patient had history of previous surgery, peritonitis, some operative procedure, ostomy, wound dehiscence. We should have a preventive attitude towards any risk factor at any stage- Before, During and After surgery and CECT-Abdomen is a helpful tool in establishing need of re-laparotomy.
References
McCune WS, Keishishian JM. Postoperative intestinal obstruction. Surg Gynecol Obstet. 1953;96:567-72.
Becker WF. Acute adhesive ileus: a study of 412 cases with particular to the abuse of tube decompression in treatment. Surg Gynecol Obstet. 1952;95:472-6.
Miller EM, Winfield JM: Acute intestinal obstruction secondary to postoperative adhesions. Arch Surg. 1959; 78: 952-957
Coletti L, Bossart PA. Intestinal obstruction during the early postoperative period. Arch Surg. 1964;88:774-8.
Sykes PA, Schofiled PF. Early postoperative small bowel obstruction. Br J Surg. 1974;61:594-600.
Welch CE. Intestinal obstruction. West J Surg Obstet Gynecol. 1959;67:90-7.
Bizer LS, Liebling RW, Delany HM. Small bowel obstruction: the role of nonoperative treatment in simple intestinal obstruction and predictive criteria for strangulation obstructon. Surg. 1981;89:407-13.
Quan SHQ, Stearns MW. Early postoperative intestinal obstruction and postoperative intestinal ileus. Ann Surg. 1980;191:72-4.
Frager D, Medwid SW, Baer JW, Mollinelli B, Friedan M. CT of small bowel obstruction: value in establishing the diagnosis and determining the degree and cause. AJR. 1994;161:37-41.
Balthazar EJ, Cho KC, Medwig SW, Birnbaum BA, Noz ME. Bowel obstruction: evaluation with CT. Radiol. 1991;180:313-8.
Fukuya T, Hawes DR, Lu CC, Chang PJ, Barlon TJ. CT diagnosis of small-bowel obstruction; efficacy in 60 patients. AJR. 1992;158:765-9.
Gazelle GS, Goldberg MA, Wittenberg J, Halpern EF, Pinkney L, Mueller PR. Efficacy of CT in distinguishing small bowel obstruction from other causes of small-bowel dilatation. AJR. 1997;162:43-7.
Maglinte DD, Gage SN, Harmon BH. Obstruction of the small intestine: accuracy and role of CT in diagnosis. Radiol. 1993;162:43-7.
Brolin RE. Partial small bowel obstruction. Surg. 1984;95:145-9.
Steward RM, Page CP, Brender J. The incidence and risk of early postoperative small bowel obstruction. Am J Surg. 1987;154:643-7.
Qatromoni JC, Rosoff L, Halls JM, Yellin AE. Early postoperative small bowel obstruction. Ann Surg. 1980;191:72-4.
Zaslow J. Early postoperative mechanical intestinal obstruction following the removal of ruptured, gangrenous appendix. Am J Surg. 1944 65:276-80.
Mollitt DL, Ballantine TVN, Grosfeld JL. Postoperative intussusceptions in infancy and childhood: analysis of 119 cases. Surg. 1979;86:402-8.