Abstract
Objective : A diagnostic method which is able to pick up easily, rapidly, and precisely patients who have strangulated intestinal obstruction from those with postoperative intestinal obstruction was studied.
Subjects and methods : D Subjects were consecutive 374 patients with postoperative intestinal obstruction, including 32 with strangulated and 342 with non-strangulated, who demanded hospital stay for treatment from January 1999 to March 2005. They were retrospectively studied whether there were significant correlations between clinical findings suggestive of strangulation and the postoperative diagnosis. Then clinical findings showing a statistically significant difference were made into scores to create the strangulation scores. II) A total of 81 patients with postoperative intestinal obstruction who demanded hospital stay for treatment from April 2005 to August 2006 were enrolled in a retrospective study to examine the usefulness of the strangulation scores, using those scores.
Results : D A univariate analysis disclosed significant correlations between strangulation and eight factors, including white blood cell count, CRP value, CK value, B.E. value, characteristic abdominal CT findings, ascites, efficacy of pentazocine for abdominal pain, and peritoneal signs. Referring results of a multivariate analysis of these eight factors, the strangulation scores were made. II) We were able to pick up strangulated cases with the sensitivity of 100% and specificity of 95.4%.
Conclusion : The use of this strangulation scores might be capable of making the correct diagnosis of strangulated intestinal obstruction.
