Preoperative Diagnosis of Strangulated Bowel Obstruction

Abstract

Since a strangulated bowel obstruction occasionally progress to a serious condition, early and precise diagnosis in patients with symptoms related with bowel obstruction is important. In the present study, we aimed to identify indicators for the preoperative diagnosis of strangulated bowel obstruction. We divided 107 patients diagnosed intraoperatively as having bowel obstruction into 2 groups according to the presence of bowel ischemia. The clinical findings, laboratory and blood gas analysis data, and the findings of enhanced CT of the patients were evaluated. Univariate analysis indicated significant differences in the peritoneal irritation sign, white blood cell count (WBC), lactate dehydrogenase (LDH) levels, ascites, abnormal run of vessels, elevation of the mesentery density, closed loop obstruction, and reduced enhancement of the intestinal wall between the two groups. Multivariate analysis indicated closed loop obstruction (P<0.001). Evaluation of the peritoneal irritation sign, WBC, LDH levels, ascites, elevation of the mesentery density, and closed loop obstruction can be helpful for early diagnosis of strangulated bowel obstruction.