Original CommunicationPredictive value of procalcitonin for bowel ischemia and necrosis in bowel obstruction
Section snippets
Study design and population
All adult (over 14 years of age) patients admitted to our department with a diagnosis of acute complete mechanical small- or large-bowel obstruction from January to December 2005 were included in this prospective study. Institutional Review Board approval was obtained before study initiation, and written informed consent was obtained by all patients before enrollment in the study. Patients with incomplete obstruction, paralytic ileus, and acute mesenteric ischemia were excluded. There was no
Results
Our hospital has a total of 800 beds, 100 of which are surgical. In our department, approximately 2,000 operations are performed per year. During the 1-year period of our study, 242 consecutive patients with acute small- or large-bowel obstruction were admitted and comprised our total study population. Mechanical bowel obstruction was confirmed in all operatively treated patients and in all patients undergoing CT. The majority of the 242 patients (n = 183; 75.6%) had small bowel obstruction.
Discussion
Acute bowel obstruction is a major cause of morbidity and financial expenditure in hospitals and a notable cause of admissions to emergency surgical departments.1, 2, 3, 4, 5 Diagnosis of bowel strangulation is based traditionally on classic signs, namely, tachycardia, hypotension, fever, constant pain, peritoneal signs, leukocytosis, base deficit, and metabolic acidosis.6, 9, 11, 12, 13, 14, 26 Abdominal CT is also useful.14, 27 Prompt, appropriate treatment of this condition is critical;
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