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Prediction of bowel obstruction caused by obturator hernia using risk factor categories on clinical characteristics and multidetector computed tomographic findings
Abdominal Radiology ( IF 2.3 ) Pub Date : 2020-11-03 , DOI: 10.1007/s00261-020-02838-3
Jing Zhang 1 , Chun-Lai Zhang 1 , Lian-Qin Kuang 2 , Xiao-Guang Li 1 , Wei Tang 3 , Yi Wang 1
Affiliation  

Purpose

To detect risk factors on clinical characteristics and multidetector computed tomographic (MDCT) findings for predicting bowel obstruction in patients with obturator hernia.

Methods

We retrospectively reviewed 47 patients who had an obturator hernia diagnosed by MDCT and/or surgery. The patients were divided into obstruction and non-obstruction group based on the presence or absence of bowel obstruction on MDCT images. Uni- and multivariate analyses were performed to identify risk factors for predicting bowel obstruction.

Results

There were 26 patients (55.32%) in the obstruction group and 21 patients (44.68%) in the non-obstruction group. Patients in the obstruction group were older (P = 0.002) and had more women (P = 0.033) and lower body mass index (BMI) (P = 0.0001) than patients in the non-obstruction group. The non-obstruction group suffered fewer bowel obstruction symptoms (P = 0.0001), Howship-Romberg (HR) sign (P = 0.012), deaths (P = 0.008) and major postoperative complications (P = 0.047). The hernia sac in the obstruction group had greater mean major diameter (P = 0.0001) and volume (P = 0.001) than those in the non-obstruction group. Multivariate analysis showed that age [odds ratio (OR) 1.18, 95% confidence interval (CI) 1.00–1.39, P = 0.046] and major diameter of hernia sac (OR 68.17, 95% CI 4.52–1027.70, P = 0.002) were independent risk factors associated with bowel obstruction in patients with obturator hernia.

Conclusions

Patient’s age and major diameter of hernia sac are independent risk factors resulting in bowel obstruction in patients with obturator hernia. Obturator hernia repair before bowel obstruction development may result in better outcomes and fewer postoperative complications.



中文翻译:

使用临床特征的危险因素类别和多排螺旋计算机断层扫描结果预测闭孔疝引起的肠梗阻

目的

检测临床特征和多排螺旋计算机断层扫描 (MDCT) 结果的危险因素,以预测闭孔疝患者的肠梗阻。

方法

我们回顾性分析了 47 名通过 MDCT 和/或手术诊断为闭孔疝的患者。根据MDCT图像有无肠梗阻将患者分为梗阻组和非梗阻组。进行单变量和多变量分析以确定预测肠梗阻的危险因素。

结果

梗阻组26例(55.32%),非梗阻组21例(44.68%)。与非梗阻组患者相比,梗阻组患者年龄更大(P  = 0.002),女性更多(P  = 0.033),体重指数(BMI)更低(P  = 0.0001)。非梗阻组肠梗阻症状(P  =0.0001)、Howship-Romberg(HR)征(P  =0.012)、死亡(P  =0.008)和术后主要并发症(P  =0.047)较少。梗阻组疝囊的平均大径(P  =0.0001)和体积(P = 0.001) 高于非阻塞组。多变量分析显示,年龄 [优势比 (OR) 1.18, 95% 置信区间 (CI) 1.00–1.39, P  = 0.046] 和疝囊大直径 (OR 68.17, 95% CI 4.52–1027.70, P  = 0.002)闭孔疝患者肠梗阻的独立危险因素。

结论

患者年龄和疝囊大径是导致闭孔疝患者肠梗阻的独立危险因素。在肠梗阻发展之前进行闭孔疝修补术可能会带来更好的结果和更少的术后并发症。

更新日期:2020-11-03
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