Long-term Outcome After Hospitalization for Small-Bowel Obstruction

Abstract

Objective: To determine the recurrence rate of smallbowel obstruction and differences in recurrence rates stratified by cause of obstruction and method of treatment. Design: Retrospective chart review with average follow-up of 53 months (range, 0 to 129 months). Setting: Combined community hospital/clinic tertiary referral center. Patients: 309 consecutive patients with documented mechanical small-bowel obstruction hospitalized from 1981 to 1986. Main Outcome Measures: Recurrence rates by the actuarial life-table method and comparisons made by the Wilcoxon and log-rank tests. Results: Recurrent obstruction developed in 34% of all patients by 4 years and in 42% by 10 years. Recurrence rates were 29% and 53% in the patients who did and did not undergo surgery (P=.002). The recurrence rate in patients with surgery was 56% for malignant neoplasms, 28% for adhesions, and 0% for hernia. Recurrence rates were 50% and 40% for patients with and without prior multiple obstructions (P=.7). Conclusions: The long-term risk of recurrent smallbowel obstruction is high. The risk is lessened by operation but not eliminated. The risk of recurrence increases with longer duration of follow-up, but most recurrences occur within 4 years. Multiple prior obstructions did not increase the risk of future obstruction. (Arch Surg. 1993;128:765-771)