Mechanical Bowel Obstruction and Related Risk Factors on Morbidity and Mortality

Abstract

Background: Mechanical bowel obstruction is a common emergency problem resulting in high morbidity and mortality. In this study, we aimed to investigate the clinical presentation and outcome of the patients who underwent surgery due to mechanical bowel obstruction, as well as the effective risk factors on morbidity and mortality.

Methods: Between January 2005 and December 2010, 148 patients who underwent surgery with a diagnosis of MBO were evaluated retrospectively.

Results: The common cause of mechanical bowel obstruction was benign diseases (79.1%), such as adhesions (48.6%) and sigmoid torsion (15.5%), while 20% of causes were malignancies, like colorectal (16.2%) and small bowel tumors (3.4%). The 56.8% of the patients underwent surgery in the first 24 hours. Intra-operatively, severe ischemic features in the bowel were determined in 48% of the patients, while perforation in 2.7% and necrosis in 7.4%. Resection procedures were performed in 60.1%, while 37.8% of the patients underwent adhesiolysis. Morbidity rate was 41.9%, and 12.8% of the patients had died. While age, comorbidity, etiology, admission time and respiratory complications were the risk factors for mortality, age, comorbidities, admission time, and surgical procedures were effective on morbidity. Independent risk factors were comorbidity and admission time for morbidity and mortality, while age for only mortality.

Conclusion: Morbidity and mortality rates may be decreased with considering the etiological causes and the related risk factors of the patients, and increasing the awareness of the public about mechanical bowel obstruction.




doi:10.4021/jcs19w