Systemic inflammatory response syndrome (SIRS) as a predictor of strangulated small bowel obstruction.
OBJECTIVE
Strangulated small bowel obstruction may often carry severe morbidity or mortality when a differential diagnosis from simple small bowel obstruction was made in the past. The aim of this study is to clarify preoperative indications that can be useful for predicting strangulation in acute small bowel obstruction, and to evaluate the efficacy of systemic inflammatory response syndrome as a predictor.


METHODS
Seventy clinical cases were rated between strangulated (n=40) and simple (n=30) small bowel obstruction that were postoperatively identified and were analyzed using univariate and multivariate procedure.


RESULTS
Age (p=0.0377), female gender (p=0.0121), white blood cells counts (p=0.0272), presence of abdominal tenderness (p=0.0074), presence of abdominal muscle guarding (p=0.0002), American Society of Anesthesiology score (p=0.0191), number of systemic inflammatory response syndrome factors (p=0.0001), and presence of systemic inflammatory response syndrome (p=0.0001) were evaluated for correlated predictive factors in the univariate analysis. The presence of systemic inflammatory response syndrome (odds ratio= 14.3, p=0.0151) and presence of abdominal muscle guarding (odds ratio=5.87, p=0.0158) were independent predictive factors in the multivariate analysis.


CONCLUSIONS
These predictive factors were considered to be useful to predict strangulated small bowel obstruction, and to contribute to the improvement of outcomes in the management of acute small bowel obstruction.
Tsumura
Hiroaki
H
Department of Surgery, Hiroshima Municipal Funairi Hospital, Hiroshima, 730-0844 Japan. tuntun1234@hotmail.com
Ichikawa
Toru
T
Hiyama
Eiso
E
Murakami
Yoshiaki
Y
Sueda
Taijiro
T
D000208:Acute Disease; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006547:Hernia / Q000175:diagnosis; D059685:Herniorrhaphy; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis* / Q000601:surgery; D007082:Ileum / Q000601:surgery; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D013223:Statistics as Topic; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology*; D000267:Tissue Adhesions / Q000175:diagnosis / Q000601:surgery