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Revista Colombiana de Cirugía
Print version ISSN 2011-7582On-line version ISSN 2619-6107
Abstract
BOLIVAR-RODRIGUEZ, Martín Adrián et al. Clinical-tomographic analysis in adhesive small bowel obstruction according to obstruction site in the tomography. rev. colomb. cir. [online]. 2022, vol.37, n.1, pp.83-89. Epub Mar 17, 2022. ISSN 2011-7582. https://doi.org/10.30944/20117582.957.
Introduction.
Postoperative adhesions are the most common cause of small bowel obstruction. The clinical presentation suggests the diagnosis, but imprecisely the cause and the site of the obstruction. Contrast computed tomography is the optimal study and allows the timely identification of patients requiring surgical intervention. The objective of this study was to analyze the correlation between the symptoms and the obstruction site detected in the abdominal contrasted computed tomography in patients with suspected diagnosis of small bowel obstruction due to adhesions.
Methods.
Prospective, cross-sectional and analytical study of patients with clinical suspicion of small bowel obstruction due to adhesions and surgical history, and its correlation with the obstruction site detected in the abdominal contrasted computed tomography, during March 2016 to February 2019 in a secondary level hospital.
Results.
Forty-one patients were included, the mean age was 59 years and the male gender was the most frequent (68.3%, n=28); the absence of evacuations was present in 97.5% (p=0.026). Contrast computed tomography showed the obstruction site in 73% of the patients. The most prevalent location of the obstruction was in the distal ileum (31.7%, n=13). It was associated with leukocytosis (p=0.041) and more intense pain (p=0.049), without presenting peritoneal irritation.
Conclusion.
The obstruction located in the distal ileum was characterized by more pain and a higher white blood cell count, without correlation as a risk factor for requiring surgical treatment.
Keywords : intestinal obstruction; small intestine; adhesions; computed tomography; diagn.