Factors Predictive of the Need for Intestinal Resection in Patients with Non-postoperative Strangulated Ileus

Abstract

Purpose: Strangulated ileus requires emergency surgery. Some patients require only adhesiolysis, but some require intestinal resection due to necrosis. We compared less-invasive cases requiring only adhesiolysis with those requiring intestinal resection and examined risk factors of these latter cases.
Target and Method: We examined 32 patients with strangulated ileus and no history of laparotomy (15 patients with intestinal resection and 17 without). We retrospectively examined patient background factors (age, sex, body mass index [BMI], and medical history), preoperative factors (white blood cell count [WBC], C-reactive protein [CRP], systemic inflammatory response syndrome [SIRS], computed tomography (CT) findings, and time from onset to surgery), and postoperative factors (operation time, length of hospital stay, complications, and cause of the ileus).
Results: The average age of the 6 men and 11 women with intestinal tract resection was 70.3±14 years old. Among them, and 4 had WBC 12782±4527/μl, CRP 2.26 (0.03–11) mg/dl, and SIRS. The average time from onset to surgery was 15.8 (6–52) hours. Compared to those without intestinal resection, more patients with intestinal resection were women, WBC and CRP values were higher, time from onset to surgery was longer.
Conclusion: In patients with strangulated ileus and no history of laparotomy, a higher number of preoperative inflammatory responses occurred in women, and the risk of intestinal resection was higher in those whose time from onset to surgery was longer.