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A Prediction Model to Differentiate Transient Ischemia from Irreversible Transmural Necrosis in Closed-loop Small Bowel Obstruction

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Specialty General Medicine
Date 2024 Sep 26
PMID 39323473
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Abstract

Introduction: The study aims to develop a prediction model to differentiate transient ischemia from irreversible transmural necrosis in closed-loop small bowel obstruction (CL-SBO).

Methods: A total of 180 participants with CL-SBO between January 2010 and December 2019, of which 122 had complete radiologic data, were included to investigate the significant clinical and imaging characteristics for differentiating patients with necrosis from transient ischemia. A logistic regression model was developed and validated.

Results: In a multivariate analysis, the American Society of Anesthesiologists physical status classification system >2 is the independent predictor for transmural necrosis. Another multivariate analysis, including clinical and imaging factors, revealed that the imaging sign of mesenteric vessel interruption was an independent risk factor for necrosis. The diagnostic model developed using these two factors has excellent performance among the validation sets, with an area under the curve of 0.89.

Conclusion: The diagnostic model and innovative imaging signs have substantial potential in solving this complex clinical problem.

References
1.
Jancelewicz T, Vu L, Shawo A, Yeh B, Gasper W, Harris H . Predicting strangulated small bowel obstruction: an old problem revisited. J Gastrointest Surg. 2008; 13(1):93-9. DOI: 10.1007/s11605-008-0610-z. View

2.
Yoon J, Lee S . The neutrophil-to-lymphocyte ratio has feasible predictive value for hospital mortality in patients with small bowel obstruction in the emergency department. Am J Emerg Med. 2020; 44:428-433. DOI: 10.1016/j.ajem.2020.05.049. View

3.
Chin R, Lima D, Pereira X, Romero-Velez G, Friedmann P, Dawodu G . Assessing outcomes in laparoscopic vs open surgical management of adhesive small bowel obstruction. Surg Endosc. 2022; 37(2):1376-1383. DOI: 10.1007/s00464-022-09314-7. View

4.
Li B, Qi W, Yuan M, Wang H, Chen M, Song Z . Increased Attenuation of Intestinal Contents at CT Indicates Bowel Necrosis in Closed-Loop Small Bowel Obstruction. Radiology. 2024; 310(2):e231710. DOI: 10.1148/radiol.231710. View

5.
Di Saverio S, Birindelli A, Broek R, Davies J, Mandrioli M, Sallinen V . Laparoscopic adhesiolysis: not for all patients, not for all surgeons, not in all centres. Updates Surg. 2018; 70(4):557-561. PMC: 6244716. DOI: 10.1007/s13304-018-0534-4. View