Acute mechanical bowel obstruction: A 5-year experience in a training and research hospital
Mehmet Karabulut1, Murat Gönenç1, Filiz İslim2, Mustafa U. Kalaycı1, Selin Kapan1, Ahmet N. Turhan1, Hakan Yırgın1, Halil Alış1
1Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi, Genel Cerrahi, İstanbul, Türkiye
2Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi, Radyoloji, İstanbul, Türkiye
Purpose: The outcomes of the patients who have been managed with the diagnosis of acute mechanical bowel obstruction were reviewed.
Patients and Methods: Medical recordings of the patients who have been managed for acute mechanical bowel obstruction between January 2005 and January 2010 were reviewed. Documented parameters were demographic data, etiological factors, the overall accuracy of the imaging study in patients who had computerized tomography scan, performance of diagnostic and/or therapeutic colonoscopy, the type of treatment, and total length of hospital stay, morbidity and mortality rates.
Results: Medical data revealed a total of 400 patients that fit the criteria. The mean age was 55.4 years, and 71% of patients were male. The most common etiological factor was peritoneal adhesions. The accuracy of computerized tomography was found to be 96.2%. Forty five patients had emergency colonoscopy, and 16 of these patients had therapeutic colonoscopy. The rate of morbidity and mortality was 24% and 12.5%, respectively. The mean length of hospital stay in patients who had conservative treatment and surgical treatment was 1.82 and 6.50 days, respectively.
Conclusion: The cornerstone of management in patients with acute mechanical bowel obstruction seems to be composed of clinical evaluation and computerized tomography scan. Identification of the patients with acute mechanical bowel obstruction who need emergency surgery is of paramount importance, because of significant increase in both morbidity and mortality rates associated with delayed treatment. Of note, it should be kept in mind that emergency colonoscopy may serve as not only a diagnostic, but also a therapeutic tool in selected patients.
Keywords: Bowel obstruction, acute intestinal obstruction, emergency colonoscopy