Clinical features of strangulated small bowel obstruction

The causes of strangulated small bowel obstruction (SSBO) include a fibrous cord, torsion, and internal hernia. We conducted this study to define the clinical features of SSBO. We reviewed the clinical course and preoperative data of 74 patients treated for SSBO in Kumamoto Regional Medical Center between January 2004 and September 2010. Twenty-one patients had no history of laparotomy. Computed tomography (CT) showed high positivity (86.3 %) of closed loops in the involved intestine. Postoperative complications developed in 23 patients, representing a morbidity rate of 31.1 %. Forty-four patients underwent resection of non-viable small intestine (non-viable group), and 30 did not require resection of the intestine (viable group). There were four hospital deaths in the non-viable group. The overall mortality rate and the mortality rate in the non-viable group were 5.4 and 9.1 %, respectively. These findings indicate that SSBO can occur without a history of laparotomy, CT is useful in its diagnosis, and its associated morbidity and mortality are high.