title: Small bowel obstruction: early parameters predicting the need for surgical intervention.
abstract: OBJECTIVE
  To study and identify early clinical and radiological findings that could help to predict operative intervention for small bowel obstruction.
  
  
  METHODS
  One hundred and nine consecutive patients with small bowel obstruction who underwent small bowel follow-through examination with Gastrografin(®) during 2005-2006. The patients were divided into an operative group and a non-operative group, n = 44 and 65, respectively. Findings primarily noted were those which were possible to register within 1-4 h from hospital arrival.
  
  
  RESULTS
  In univariate analyses, factors found to be significantly associated with surgical intervention were no prior abdominal surgery, the presence of radiological differential air fluid levels, and absence of flatulence 24 h prior to admission, CRP > 10 mg/L and dehydration at admission. In multivariate analyses, the presence of dehydration and radiological differentiated air fluid levels were independent predictive factors of significance. Absence of all factors significantly favored non-operative treatment, while operative treatment was significantly favored when two or more factors were present.
  
  
  CONCLUSIONS
  The presence of two or more early predictive factors as defined above, available at admission, significantly correlates with a likelihood of complete obstruction and the need of surgical intervention.
authors.affiliation: Department of Surgery, University of Lund, University Hospital of Lund, 221 85, Lund, Sweden. karolin.isaksson@med.lu.se.
authors.forename: K
authors.initials: K
authors.lastname: Isaksson
authors.affiliation: Department of Surgery, University of Lund, University Hospital of Lund, 221 85, Lund, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Weber
authors.affiliation: Department of Surgery, University of Lund, University Hospital of Lund, 221 85, Lund, Sweden.
authors.forename: R
authors.initials: R
authors.lastname: Andersson
authors.affiliation: Department of Surgery, University of Lund, University Hospital of Lund, 221 85, Lund, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Tingstedt
keywords: Differentiated air fluid levels; Predictive value; Small bowel follow-through; Small bowel obstruction
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