Study of the Outcome of Emergency Small Bowel Resections Regarding Morbidity and Mortality

Abstract

Background: Management of small intestinal diseases in the emergency setting, imposes a challenge and is associated with incidence of perioperative mortality and morbidity. Many factors may contribute to this adverse outcome, it may be patient-related factors, associated colonic injuries or related to presenting derangement locally or systemically. Objective: To rate the reported morbidity and mortality after small bowel emergencies with resections and reanastomosis and the impact of preoperative, operative and postoperative factors on patients' outcomes. Patients and Methods: A total of 60 patients who underwent emergent small bowel resection were included in this study. This study was performed using data from patients of both sexes aged above 12 years old who presented with small bowel emergencies that needed emergency resection, which were managed in the General Surgery Department of Aswan University Hospital, during the period from March 2019 until February 2020. Results: There was a statistically significant difference between them regarding age groups, the prevalence of comorbidities and previous abdominal surgeries. We found that associated injuries were associated with the most added risk of morbidity and time of presentation in the multivariate module, followed by hemodynamic instability. The two independent modifiable variables were the hemodynamic instability after initial resuscitation and the choice of simplest shortest appropriate operative option. Conclusion: Regarding morbidity, there was significant effect of age and the presence of comorbidities. These results may aid the acute-care surgeons in identifying patients with a high-risk for postoperative complications and fatal outcomes.