Increased length of incarcerated small bowel as a risk factor for intestinal necrosis in obturator hernia.

Autor: Kiyasu Y; Gastroenterological Surgery, Kameda Medical Center, 929 Higashi-Cho, Kamogawa, Chiba, 296-8602, Japan. ykiyasu@kuhp.kyoto-u.ac.jp.; Department of Surgery, Graduate School of Medicine, Kyoto University, University, 54 Shogoin- Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan. ykiyasu@kuhp.kyoto-u.ac.jp., Oka N; Gastroenterological Surgery, Kameda Medical Center, 929 Higashi-Cho, Kamogawa, Chiba, 296-8602, Japan.; Emergency and Trauma Center, Kameda Medical Center, 929 Higashi-Cho, Kamogawa, Chiba, 296-8602, Japan., Mike M; Gastroenterological Surgery, Kameda Medical Center, 929 Higashi-Cho, Kamogawa, Chiba, 296-8602, Japan., Kusanagi H; Gastroenterological Surgery, Kameda Medical Center, 929 Higashi-Cho, Kamogawa, Chiba, 296-8602, Japan.
Jazyk: angličtina
Zdroj: Hernia : the journal of hernias and abdominal wall surgery [Hernia] 2024 Dec 02; Vol. 29 (1), pp. 38. Date of Electronic Publication: 2024 Dec 02.
DOI: 10.1007/s10029-024-03234-2
Abstrakt: Background: Incarcerated obturator hernia (OH) is a rare type of pelvic wall hernia. With the increasing adoption of reduction techniques for incarcerated OH, it is crucial to assess the extent of damage to the incarcerated intestine. This study aimed to identify objective risk factors for intestinal necrosis based on computed tomography (CT) findings.
Methods: From October 2004 to June 2013, data from consecutive patients diagnosed with incarcerated OH at Kameda Medical Center were collected. All patients underwent laparotomy and were classified into either the viable group (no incarceration-related intestinal damage) or the necrosis group (incarceration-related intestinal damage present). Patient characteristics and CT findings were retrieved retrospectively, including incarcerated intestine length, obturator canal width, and precise location of incarceration. Multivariate logistic regression with backward elimination was performed to identify risk factors for intestinal necrosis.
Results: A total of 37 patients were included, with 25 in the viable group and 12 in the necrosis group. Multivariate analysis revealed that increased incarcerated intestine length on CT was significantly associated with necrosis (p = 0.004; odds ratio, 1.19 per 1-mm increase; 95% confidence interval, 1.06-1.34), outweighing other factors such as white blood cell count, C-reactive protein levels, and time from onset to hospital arrival.
Conclusion: Length of the incarcerated small bowel on CT may be a potential risk factor for intestinal necrosis in patients with OH.
Competing Interests: Declarations. Conflict of interest: All the authors declare no conflict of interest. Ethical approval: This study protocol was approved by the institutional review board of Kameda Medical Center (17–208). Human and animal rights: This study was performed in line with the principles of the Declaration of Helsinki. Informed consent: With institutional review board approval, an opt-out method was used due to the retrospective nature of the study, and anonymized data were handled in accordance with privacy regulations.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)
Databáze: MEDLINE
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