ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2022
Diagnosis of single adhesive bands versus matted adhesions in small bowel obstructions: a radiological predictive score.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 8 citations in OpenAlex.
- A multi-analysis of nomogram model for the identification of banded adhesions and matted adhesions in adhesive small bowel obstruction.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
- Focus on emergency general surgery.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Application of a Radiological Predictive Score of Single Band Adhesion to Predict the Failure of the Medical Management of Small Bowel Obstruction: a Retrospective Monocentric Cohort.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
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Authors and funding
7 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeThe objective was to develop a radiological score obtained from multi-detector computed tomography (MDCT) to differentiate between single band adhesion (SBA) and matted adhesions (MA) as the etiology of small bowel obstruction (SBO).
methodsAll consecutive patients who underwent surgery from January 2013 to June 2018 for adhesion-induced SBO were retrospectively included.
resultsAmong the 193 patients having surgery for SBO, 119 (61.6%) had SBA and 74 (38.4%) had MA surgically proven. In multivariate analysis, the presence of a beak sign (OR = 3.47, CI [1.26; 9.53], p = 0.02), a closed loop (OR = 11.37, CI [1.84; 70.39], p = 0.009), focal mesenteric haziness (OR = 3.71, CI [1.33; 10.34], p = 0.01) and focal and diffuse peritoneal fluid (OR = 4.30, CI [1.45; 12.73], p = 0.009 and OR = 6.34, CI [1.77; 22.59], p = 0.004, respectively) were significantly associated with SBA. Conversely, the presence of diffuse mesenteric fluid without focal fluid (OR = 0.23, CI [0.06; 0.92], p = 0.04) and an increase of the diameter of the most dilated loop (OR = 0.94, CI [0.90; 0.99], p = 0.02) were inversely associated with SBA. Using the significant predictive factors of SBA, we built a composite score to radiologically predict the etiology of SBO. The area under the receiver operating characteristic (ROC) curve of the score was 0.8274. For a cut-off score of -0.523, sensitivity, specificity and the percentage of patients correctly classified were 78.4%, 84.6% and 80%, respectively. If the score is ≥ 7, the probability that the mechanism of SBO is not SBA was 100%.
conclusionsThe present score, validated in a different population, could be a significant tool in the decision for surgical management.
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