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Acute small bowel obstruction: one‐year retrospective study of admissions to inner city Royal Perth Hospital
Author(s) -
Cengarle Alessandro,
Weber Dieter G.,
Taib Adnan G.
Publication year - 2020
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.16177
Subject(s) - medicine , interquartile range , bowel obstruction , retrospective cohort study , conservative management , surgery
Background Analyse admissions to Royal Perth Hospital (RPH) with acute small bowel obstruction (SBO), and identify trends between outcomes and management. Methods Retrospective, single‐centre review of patients admitted to RPH with acute SBO, between May 2017 and May 2018. Results A total of 251 admissions met inclusion criteria. Increasing age correlated with increasing total length of stay (LOS) ( r = 0.134, P = 0.033) and post‐operative LOS ( r = 0.349, P < 0.0001). Increasing age led to poorer outcomes ( P < 0.0001). Diagnoses were most commonly adhesions (167/251 = 66.5%), hernias (47/251 = 18.7%) and inflammatory bowel diseases (11/251 = 4.4%). Operation rate for adhesional SBO was 24.6% (41/167) and non‐adhesional SBO 54.8% (46/84). Median total LOS for operative versus conservative management was 9 days (interquartile range (IQR) 8) versus 3 days (IQR 3) ( P < 0.0001). Median time to surgery was 1 day (IQR 2). Increased time from admission to theatre led to increasing post‐operative LOS ( r = 0.398, P = 0.0013). Median post‐operative LOS for bowel resection versus no resection was 9 days (IQR 4.5) versus 6 days (IQR 4) ( P = 0.0128). Of 101, 81 (80.2%) adhesional SBO resolved non‐operatively after receiving Gastrografin, compared to 45 of 66 (68.2%) of those who did not ( P = 0.07). It did not significantly alter total or post‐operative LOS ( P = 0.65 and P = 0.96), patient outcome ( P = 0.26), or need for bowel resection ( P = 0.63). Conclusions Operative management, bowel resection, older age and increasing time from admission to surgery increase LOS. Trial of Gastrografin in non‐operative management of adhesion type small bowel obstructions does not significantly affect outcomes but tends to reduce operative rates.