| Theme |
Diagnosis and Treatment of Intestinal Obstruction: Timing in Consulting a Surgeon |
| Title |
Timing of Surgery for Simple Small Bowel Obstructions |
| Author |
Masatoshi Isogai |
Department of Surgery, Ogaki Municipal Hospital |
| Author |
Akihiro Yamaguchi |
Department of Surgery, Ogaki Municipal Hospital |
| Author |
Keigo Mizutani |
Department of Surgery, Ogaki Municipal Hospital |
| [ Summary ] |
In the Department of Surgery at the Ogaki Municipal Hospital, the timing of surgery for simple small bowel obstructions has been determined based on images made with Gastrografin administered through a nasogastric tube early after admission. Of the five hundred and fifteen patients admitted with simple small bowel obstructions during the past five years since CT scanning has been introduced as a complementarily method to evaluate patients with small bowel obstruction, sixty eight (13.2%) have undergone surgery. The average duration of conservative treatment was 3.7 days. Of the sixty eight patients who underwent surgery, 39 (57.4%) were diagnosed as being candidates for surgery within forty eight hours after admission. Compared with our previous series, the number of patients treated successfully with conservative methods has increased. It is likely that the number of patients treated successfully with conservative methods increased under meticulous observation based on CT scans. These patients, may otherwise have been candidates for surgery in our previous series. Therefor, the timing of surgery for simple small bowel obstructions should be judged independently in each case, based on both Gastrografin images and on meticulous observation with CT scans. |