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  • Small bowel obstruction in the virgin abdomen: the need for a mandatory laparotomy explored

    Author(s)
    Beardsley, Christian
    Furtado, Ruelan
    Mosse, Charles
    Gananadha, Sivakumar
    Fergusson, James
    Jeans, Phil
    Beenen, Edwin
    Griffith University Author(s)
    Beardsley, Christian J.
    Year published
    2014
    Metadata
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    Abstract
    Background A laparotomy is still considered mandatory for patients without previous abdominal surgery presenting with a small bowel obstruction (SBO) because of a perceived high incidence of underlying lesions. However, there is no evidence in literature to support this assumption. We analyzed the etiology of SBO in this subgroup of patients to establish the need for a mandatory laparotomy. Methods A retrospective analysis was conducted over a 5-year period. Basic demographics, radiology results, operative findings, and outpatient investigations were analyzed. Results Of 689 patients presenting with an SBO, a total of 62 ...
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    Background A laparotomy is still considered mandatory for patients without previous abdominal surgery presenting with a small bowel obstruction (SBO) because of a perceived high incidence of underlying lesions. However, there is no evidence in literature to support this assumption. We analyzed the etiology of SBO in this subgroup of patients to establish the need for a mandatory laparotomy. Methods A retrospective analysis was conducted over a 5-year period. Basic demographics, radiology results, operative findings, and outpatient investigations were analyzed. Results Of 689 patients presenting with an SBO, a total of 62 patients, 9.0%, had a virgin abdomen. A known underlying disease (inflammatory bowel disease, malignancy) was the cause in 13 patients. The remaining 49 patients had adhesions in 75.5% and a newly diagnosed malignancy in 10.2% as a cause. Conclusions Adhesions are by far the most likely cause of SBO in patients without previous abdominal surgery followed by a small number of newly diagnosed malignancies. Both prevalences are in equal proportion to patients with previous abdominal surgery. A trial of nonoperative management may therefore be justified.
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    Journal Title
    The American Journal of Surgery
    Volume
    208
    Issue
    2
    DOI
    https://doi.org/10.1016/j.amjsurg.2013.09.034
    Subject
    Medical and Health Sciences not elsewhere classified
    Clinical Sciences
    Publication URI
    http://hdl.handle.net/10072/67165
    Collection
    • Journal articles

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