%0 Journal Article
%T Clinical variables related to small bowel obstruction: comparison of patients with and without Crohn¡¯s disease
%A Awad Al Qahtani
%A Christina Holcroft
%A Philip Gordon
%A Andrew Szilagyi
%J Gastroenterology Insights
%D 2012
%I 
%R 10.4081/gi.2012.e14
%X Small bowel obstruction is a known complication of Crohn¡¯s disease. Determining need for operation is a demanding task. The aim of this study was to fine tune the decision-making process by evaluating standard clinical and laboratory parameters in small bowel obstruction of any cause and compare etiologies. Consecutive patients with Crohn¡¯s disease and small bowel obstruction were selected retrospectively and compared to a randomly selected group of non Crohn¡¯s patients with obstruction over a 9 year period. Twenty-two clinical, laboratory and radiological variables were assessed for the following outcomes: i) diagnosis of Crohn¡¯s; ii) operative or non operative treatment in Crohn¡¯s; iii) operative or non operative treatment without Crohn¡¯s; iv) exacerbation or adhesions causing obstruction among Crohn¡¯s patients. Multivariable models were developed for each outcome using logistic regression. Age less than 50, history of smoking, Jewish ethnicity, white count >11x10E9, neutrophils >7.5x10E9 and platelet volume <9.9 fL, supported the diagnosis of Crohn¡¯s disease. Operation in Crohn¡¯s disease within the same admission was associated with a history of smoking, temperature >38 , high pulse >100, leukocytosis (>11x10E9) and obstruction on abdominal scan, while operation in patients without Crohn¡¯s in the sentinel admission, was associated with temperature >38 , tachycardia, leukocytosis (>11x10E9) and previous operation. Confirmation of these predictive patterns in a validation group could help in clinical decisions regarding therapeutic options in an emergency setting.
%K clinical predictors
%K small bowel obstruction
%U http://www.pagepress.org/journals/index.php/gi/article/view/3293