Radiologic Score and Failure of Conservative Management of Adhesive Small Bowel Obstruction

University Hospital, Angers279 enrolled

Overview

The management of acute adhesive small bowel obstruction remains challenging for the digestive surgeon. The Bologna guidelines recommend that conservative management of aSBO. The literature reports that this form of management has a failure rate between 10 and 40%. A radiological score has been proposed and was associated with an increased risk of failure of conservative management. This tool is promising to select patients further requiring surgery but it has to be assessed in a multi centric prospective cohort.

Study Type

OBSERVATIONAL

Enrollment

279

Conditions

Small Bowel Obstruction Conservative Management Imaging

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * all the consecutive patients admitted for initial non-surgical management for aSBO * during the period of inclusion Exclusion Criteria: * the cause of SBO was functional or other than adhesive * patients requiring initial surgical management. * absence of computed tomography performed at admission

Locations (1)

Outcomes

Primary Outcomes

Angers CT score

The Angers CT score ≥5 was considered to be risk factor for failure of the medical management. Angers CT score was calculated by reading the CT scan as follow: * beak sign (+2), if not (0) * closed loop (+4), if not (0) * focal (+4) or diffuse (+4) intraperitoneal liquid, if not (0) * focal (+2) or diffuse (0) mesenteric haziness, if not (0) * focal (-3) or diffuse (-3) mesenteric liquid, if not (0) * diameter of the most dilated small bowel loop \> 40 mm (-2) (if not (0).

Time frame: immediately after the completion of the CT-scan