1. Large-bowel disease presenting as small-bowel obstruction is associated with a poor prognosis
- Author
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Vikram G. Ramjee, Ernesto A. Sepulveda, Eric Riedinger, Rebecca E. Barnett, Jessica L. Weaver, Danielle E. Patterson, Jason Younga, Robert Keskey, and William G. Cheadle
- Subjects
Adult ,Male ,medicine.medical_specialty ,Hernia ,Adolescent ,Population ,Kentucky ,Medical Records ,03 medical and health sciences ,Ileocecal valve ,Young Adult ,0302 clinical medicine ,Age Distribution ,Intestine, Small ,medicine ,Humans ,Multicenter Studies as Topic ,Hospital Mortality ,Intestine, Large ,Sex Distribution ,education ,Veterans Affairs ,Aged ,Retrospective Studies ,Aged, 80 and over ,education.field_of_study ,business.industry ,Mortality rate ,Medical record ,General surgery ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Inflammatory Bowel Diseases ,Prognosis ,Surgery ,Bowel obstruction ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Colonic Neoplasms ,Emergency Medicine ,030211 gastroenterology & hepatology ,Female ,business ,Tomography, X-Ray Computed ,Intestinal Obstruction - Abstract
Introduction Small-bowel obstruction (SBO) is a common cause of admission to the surgical service. On rare occasions, a diagnosed SBO is actually due to large-bowel pathology combined with an incompetent ileocecal valve. The purpose of this study was to investigate this phenomenon. Methods We performed a retrospective medical record review of patients that were admitted with a diagnosis of SBO at University of Louisville hospital and the Veterans Affairs hospitals in Louisville, KY, from 2006 until 2014. Results A total of 498 patients were admitted with SBO during this time period. Forty-one patients were found to have an underlying large-bowel disease. The most common large-bowel pathologies included malignancy (51%), inflammation (15%), and infection (15%). Fifteen (43%) of these patients died during admission; 93% of these were due to either their bowel obstruction or the underlying disease state. This was significantly higher than the general population (9.4% mortality, 6% due to underlying disease). Conclusions Patients that present with SBO due to a large-bowel source have a much higher mortality rate than those that present with other causes. Rapid identification of these patients will allow for more timely and appropriate treatment.
- Published
- 2015