Long-term outcome after hospitalization for small-bowel obstruction.
OBJECTIVE
To determine the recurrence rate of small-bowel obstruction and differences in recurrence rates stratified by cause of obstruction and method of treatment.


METHODS
Retrospective chart review with average follow-up of 53 months (range, 0 to 129 months).


METHODS
Combined community hospital/clinic tertiary referral center.


METHODS
309 consecutive patients with documented mechanical small-bowel obstruction hospitalized from 1981 to 1986.


METHODS
Recurrence rates by the actuarial life-table method and comparisons made by the Wilcoxon and log-rank tests.


RESULTS
Recurrent obstruction developed in 34% of all patients by 4 years and in 42% by 10 years. Recurrence rates were 29% and 53% in the patients who did and did not undergo surgery (P = .002). The recurrence rate in patients with surgery was 56% for malignant neoplasms, 28% for adhesions, and 0% for hernia. Recurrence rates were 50% and 40% for patients with and without prior multiple obstructions (P = .7).


CONCLUSIONS
The long-term risk of recurrent small-bowel obstruction is high. The risk is lessened by operation but not eliminated. The risk of recurrence increases with longer duration of follow-up, but most recurrences occur within 4 years. Multiple prior obstructions did not increase the risk of future obstruction.
Landercasper
J
J
Department of Surgery, Gundersen/Lutheran Medical Center, La Crosse, WI.
Cogbill
T H
TH
Merry
W H
WH
Stolee
R T
RT
Strutt
P J
PJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000401:mortality / Q000628:therapy*; D007421:Intestine, Small; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome