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Small Bowel Volvulus Should Be Considered in Surgical Evaluation

Cases account for 1 percent of hospitalizations for bowel obstruction among U.S. adults

WEDNESDAY, May 13, 2015 (HealthDay News) -- Among U.S. adults, small bowel volvulus cases account for 1 percent of hospitalizations for bowel obstruction, according to research published online April 29 in the American Journal of Surgery.

Taylor M. Coe, from the University of California in San Diego, and colleagues retrospectively reviewed small bowel volvulus cases in patients aged ≥18 years old using data from the Nationwide Inpatient Sample (1998 to 2010).

The researchers identified 2,065,599 hospitalizations for bowel obstruction. One percent of these were small bowel volvulus cases, of which 169 were due to intestinal malrotation. The majority of cases (89.24 percent) presented emergently, and management was operative more often than non-operative (65.21 versus 34.79 percent; P < 0.0001). Age older than 50 years, Charlson comorbidity index ≥1, emergent admission, peritonitis, acute vascular insufficiency, coagulopathy, and non-operative management were identified as predictors of mortality.

"As the first population-based epidemiological study of small bowel volvulus, our findings provide a robust representation of this rare cause of small bowel obstruction in American adults," the authors write.

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