Intestinal Fluid CT Level Could Predict Pathological Small Bowel Ischemia in Small Bowel Obstruction.

Autor: Hirao, Hiroki, Okabe, Hirohisa, Masuda, Toshiro, Ogawa, Daisuke, Uemura, Norio, Kuroda, Daisuke, Taki, Katsunobu, Tomiyasu, Shinjiro, Hirota, Masahiko, Hibi, Taizo, Baba, Hideo, Sugita, Hiroki
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Zdroj: Indian Journal of Surgery; Jun2023, Vol. 85 Issue 3, p596-601, 6p
Abstrakt: The aim of this study is to explore pivotal preoperative findings of small bowel ischemia in patients with small bowel obstruction. We enrolled 285 consecutive patients with small bowel obstruction requiring in-hospital treatment. The clinical parameters involved in small bowel ischemia were retrospectively explored. Non-enhanced computed tomography (CT) findings were analyzed. The definition of bowel ischemia was pathologically determined. The median age of the patients was 74. A total of 127 patients underwent surgery, and small bowel ischemia was observed in 26 patients. Univariate analysis revealed that ascites on CT (p = 0.0005), mesenteric haziness on CT (p < 0.0001), closed loop sign on CT (p < 0.0001), wall thickness ≥ 4 mm on CT (p = 0.0003), ascites CT level ≥ 15 Hounsfield units (HU) on CT (p = 0.0176), intestinal fluid CT level ≥ 12 HU on CT (p = 0.0052), and white blood cell > 15,000 /μL (p = 0.0223) were correlated with small bowel ischemia. Multivariate logistic regression analysis revealed that mesenteric haziness on CT (p = 0.0131), closed loop sign on CT (p = 0.0002), and intestinal fluid CT level ≥ 12 HU on CT (p = 0.0056) were independently correlated with small bowel ischemia. An intestinal fluid CT level ≥ 12 HU could be a new clinical predictor of bowel ischemia in addition to the well-known predictors of mesenteric haziness and closed loop sign on CT in patients with small bowel obstruction. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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