Zielinski et al developed a simplified model for predicting the need for an operative intervention for a patient with a small bowel obstruction (SBO). These can help to identify a patient who may benefit from early surgery. The authors are from the Mayo Clinic.
Patient selection: small bowel obstruction
Risk factors associated with surgery based on a multivariate analysis:
(1) edema of the mesentery on abdominal CT scan (OR 5.6)
(2) absence of small bowel feces sign on abdominal CT scan ("small bowel fecalization", OR 5.1)
(3) intractable constipation (obstipation, OR 3.2)
The authors recommended early surgical exploration if all 3 risk factors were present.
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