ThP6.16 - Small bowel obstruction (SBO) in NELA patients: A cohort study

Abstract

Abstract Aims SBO is characterized as mechanical or functional obstruction of intestines, accounting for 15% of acute abdomens & 50% (NASBO 2017) of emergency laparotomies each year in the UK. Aim of study is to assess the surgical management of SBO amongst NELA patients at a single centre. Methods Cohort study carried out from Jan’2014 to Jan’2023. Descriptive demography & post-operative outcomes were evaluated for SBO NELA patients. Other non SBO NELA patient were controls. Results SBO NELA(n = 560) Non SBO NELA(n = 306) Mann Whitney U(p value) Age(yrs) 68.7 65.7 < 0.005 Sex(M:F) 235 : 325 157 : 149 BMI 25.5 26.0 NS ASA 3 3 NS Op time(mins) 112.1 133.0 < 0.0001 ITU stay(n) 229 171 ITU stay(days) ± ± LOS(days) 11 16 < 0.0001 Lap(n) 176 60 Open(n) 384 246 Lactate(mmol/L) 2.0 ± 0.1 2.3 ± 0.2 NS WCC(x109/L) 12.4 ± 0.2 12.4 ± 0.4 NS CRP(mg/L) 62.2 ± 3.9 90.6 ± 5.9 < 0.0001 Physiol score 21.9 ± 0.3 23.5 ± 0.5 < 0.05 Op score 15.4 ± 0.2 19.5 ± 0.3 < 0.0001 Pre possum score 10.4 ± 0.8 21.0 ± 1.7 < 0.0001 PP mortality score 7.3 ± 0.5 9.7 ± 1.1 NS PP morbidity score 60.7 ± 1.4 75.6 ± 1.7 < 0.0001 Adhesions(n) 277 Hernias(n) 48 Other(n) 235 SB resection(n) 115 Conclusion Early radiological diagnosis & management is essential in SBO including nutritional support. Surgery is indicated in SBO where there is potential perforation, strangulation & failed conservative managements. SBO was treated laparoscopically in 31.4% of cases, adhesions (49.4%) was most causes, SB resection was undertaken in 20.5 % cases. Other causes include hernias, FB (gallstones), tumours, intussusception & volvulus.