Abstract
The relationship between the appearance of ascites and the degree of intestinal ischemia in strangulated obstruction has not been studied in detailed. The aim of this study is to elucidate the relationship between the appearance of ascites and degree of intestinal ischemia. METHOD: The subjects were 20 patients with strangulated intestinal obstruction who underwent laparotomy in our hospital. They were divided into two groups: those with intestinal necrosis (n=6); and those without (n=14). The patients were compared for frequency of ascites, systemic inflammatory response syndrome (SIRS) factors, and the serum levels of CRP, LDH and CPK. RESULTS: SIRS factors and the serum levels of CRP, LDH and CPK were not significantly associated with the presence of intestinal necrosis. Eighteen patients presented with ascites. Of the 14 patients without intestinal necrosis, 12 presented with ascites. On the other hand, all 5 patients who presented with strangulated intestinal obstruction were positive for SIRS. CONCLUSIONS: In strangulated intestinal obstruction, the appearance of ascites could be identified before the increase in SIRS factors and other serological parameters. Thus, the appearance of ascites may have a potential role in contributing to the diagnoses of early stages of intestinal ischemia in patients with strangulated obstruction.
