Indicators for surgery in adhesive bowel obstruction.
BACKGROUND
There is lack of data on risk factors, which, if present, would indicate the need for surgery in patients with adhesive bowel obstruction.


METHODS
A Cohort of 100 consecutive patients with adhesive obstruction was studied prospectively to compare clinical and investigative parameters between the operative and conservative group.


RESULTS
It was found that female gender, previous obstetric or gynaecological procedures, pulse and BP on admission, nature of nasogastric aspirate, single distended loop on abdominal x-ray as also predominant ileal distension were independent factors indicating a high probability of surgical intervention.


CONCLUSIONS
Patients with 2 or more risk factors had 12 times higher probability of surgery and in those with 3 or more the relative risk was 30 times. Patients with such risk factors should be monitored closely after admission and should be taken for surgery after an initial short trial of conservative measures.
Rajanikmanth
P V
PV
Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry-605006, India.
Kate
V
V
Ananthakrishnan
N
N
D000328:Adult; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D000267:Tissue Adhesions / Q000150:complications