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A Retrospective Study of Preoperative Predictive Factors of Strangulation in Intestinal Obstruction

Praveen S. Mali, Junior Resident, Dept. of General Surgery, Bangalore Medical College and Research Institute, Bengaluru, Karnataka 560002, India , Praveen S. Mali1 , Gayathri V.2 , Harindranath H. Ranganath3

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New Indian Journal of Surgery 9(6):p 750-755, Nov-Dec 2018. | DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9618.11

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Abstract

  Proper management of bowel obstruction requires a methodology to prevent nontherapeutic laparotomy while minimizing the chance of overlooking strangulation obstruction causing intestinal ischemia. Our aim was to identify preoperative risk factors associated with strangulating SBO and to develop a model to predict the need for operative intervention Context: We chose to re-evaluate preoperative diagnostic capability for the recognition of strangulation in a retrospective study. Aims: To identify preoperative risk factors, associated with strangulated intestinal obstruction and to develop a model to predict the need for operative intervention in such cases. Retrospectively study the symptomatology, clinical signs, biochemical markers and findings on imaging. Settings and Design: Retrospective study of sixty two patients conducted in Victoria Hospital, Bangalore Medical College and Research Institute (BMCRI) for a period of six months. Methods: Sixty two patients who underwent exploratory laparotomy for intestinal obstruction were divided into two groups and their pre operative factors were compared and tested for significance. Stastical Analysis Used: Chi Square test for value of significance (p value <0.05). Results: Out of sixty two patients, strangulation was seen in twenty four cases. Vomiting, fever, guarding etc. were co relating. Laboratory parameters were leukocytosis (>12.3 +/- 3.3), serum lactate and acidosis on arterial blood gas analysis, free fluid and dilated, aperistaltic loops on   ultrasound were significant. Conclusions: We conclude that no single factor is predictive, combination has high sensitivity, specificity and predictive value. 

Keywords: Strangulation; Intestinal Obstruction.  

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DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9618.11

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