A new clinical severity score for the management of acute small bowel obstruction in predicting bowel ischemia: a cohort study

Wassmer, Charles-Henri; Revol, R; Uhe, Isabelle; Chevallay, Mickaël; Toso, Christian; Gervaz, Pascal; Morel, Philippe; Poletti, Pierre–Alexandre; Platon, Alexandra; Ris, Frédéric; Schwenter, Frank; Perneger, Thomas; Meier, Raphaël

doi:10.1097/js9.0000000000000171

Cited by 3 publications

(1 citation statement)

References 33 publications

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“…Recent and advanced diagnostic imaging, specifically computed tomography (CT) provides a more accurate diagnosis [ 47 ]. CT is an excellent supportive tool to define bowel obstruction and provide diagnostic hallmarks for intra-abdominal hernias [ 48 , 49 ]. In a direct lesser omental hernia, a CT scan was performed in 4 of 9 studies.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous lesser omental herniation resolved by laparoscopic surgery: case report and systematic literature review

et al. 2023

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Background Despite its extremely low incidence, intra-abdominal herniation through the lesser omentum is associated with a high mortality rate and must be recognized early and treated urgently. To overcome a lack of data on the management of this condition, we collected and reviewed all the reported cases of operated lesser omental hernia and presented the case of a patient treated by laparoscopy for an isolated lesser omental hernia. Methods According to PRISMA guidelines and using PubMed, Cochrane Library, and Web of Science, a systematic literature review of cases of lesser omental hernia treated by surgery was performed on February 12, 2023. Results Of 482 articles, 30 were included for analysis and only 9 articles presented an isolated hernia through the lesser omentum. Among these, 4 patients were female and the median age was 38. Upper abdominal pain and vomiting were reported in 7 out of 9 patients. The small bowel was responsible for 78% (7/9) of all lesser omental herniations. All of them were treated by laparotomy. In addition, we describe the case of a 65-year-old woman without prior surgical history who was treated by laparoscopy for a spontaneous closed loop hernia through the lesser omentum without any other associated hernias. Conclusion Mostly associated with prior surgery or trauma, this type of herniation could sometimes occur spontaneously without any sign of peritonitis. Due to the high mortality rate, internal abdominal hernias should always be ruled out with a CT scan in front of patients presenting with persisting acute abdominal pain and no alternative diagnosis.

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Section: Discussionmentioning

confidence: 99%

Spontaneous lesser omental herniation resolved by laparoscopic surgery: case report and systematic literature review

et al. 2023

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COMMENT “A new clinical severity score for the management of acute small bowel obstruction in predicting bowel ischemia: a cohort study.”[Int J Surg. 2023; 109: 1620-28]

Yao,

Zhang,

Jiang

2023

International Journal of Surgery

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Machine Learning Approaches for the Prediction of Postoperative Major Complications in Patients Undergoing Surgery for Bowel Obstruction

Mazzotta,

Burti,

Causio

et al. 2024

JPM

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Background: Performing emergency surgery for bowel obstruction continues to place a significant strain on the healthcare system. Conventional assessment methods for outcomes in bowel obstruction cases often concentrate on isolated factors, and the evaluation of results for individuals with bowel obstruction remains poorly studied. This study aimed to examine the risk factors associated with major postoperative complications. Methods: We retrospectively analyzed 99 patients undergoing surgery from 2015 to 2022. We divided the patients into two groups: (1) benign-related obstruction (n = 68) and (2) cancer-related obstruction (n = 31). We used logistic regression, KNN, and XGBOOST. We calculated the receiver operating characteristic curve and accuracy of the model. Results: Colon obstructions were more frequent in the cancer group (p = 0.005). Operative time, intestinal resection, and stoma were significantly more frequent in the cancer group. Major complications were at 41% for the cancer group vs. 20% in the benign group (p = 0.03). Uni- and multivariate analysis showed that the significant risk factors for major complications were cancer-related obstruction and CRP. The best model was KNN, with an accuracy of 0.82. Conclusions: Colonic obstruction is associated with tumor-related blockage. Malignant cancer and an increase in C-reactive protein (CRP) are significant risk factors for patients who have undergone emergency surgery due to major complications. KNN could improve the process of counseling and the perioperative management of patients with intestinal obstruction in emergency settings.

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A new clinical severity score for the management of acute small bowel obstruction in predicting bowel ischemia: a cohort study

Cited by 3 publications

References 33 publications

Spontaneous lesser omental herniation resolved by laparoscopic surgery: case report and systematic literature review

Spontaneous lesser omental herniation resolved by laparoscopic surgery: case report and systematic literature review

COMMENT “A new clinical severity score for the management of acute small bowel obstruction in predicting bowel ischemia: a cohort study.”[Int J Surg. 2023; 109: 1620-28]

Machine Learning Approaches for the Prediction of Postoperative Major Complications in Patients Undergoing Surgery for Bowel Obstruction

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