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01-04-2019 | Soft Tissue Infection | Original Article

Predictors of ischemic bowel in patients with incarcerated hernias

Authors: J. A. Keeley, A. Kaji, D. Y. Kim, B. Putnam, A. Neville

Published in: Hernia | Issue 2/2019

Abstract

Purpose

Diagnosing intestinal strangulation in the setting of incarcerated hernias remains challenging. Hyponatremia has been identified as a predictor of necrotizing soft tissue infections and gangrenous cholecystitis. We hypothesized that hyponatremia could predict bowel ischemia in patients with incarcerated hernias.

Methods

Medical records for 163 patients with incarcerated hernias over a 5-year period were reviewed. Preoperative clinical, laboratory, and radiologic findings and final intraoperative diagnosis were collected.

Results

Thirty-six patients (22.1%) had ischemic bowel requiring resection. Univariate analysis identified multiple significant variables including lower serum sodium (p = 0.002), lower bicarbonate (p = 0.04), elevated glucose (p = 0.0002), elevated white blood cell count (p = 0.001), and skin changes (p = 0.001). In a multivariable model, skin changes were associated with an odds ratio for ischemia of 3.3 (1.3–8.6 p = 0.02). Sodium of less than 135 had an odds ratio for ischemia of 3.9 (1.7–9.1, p = 0.004).

Conclusion

Hyponatremia should raise suspicion for underlying strangulated bowel and prompt urgent exploration in patients with incarcerated hernias.

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Title: Predictors of ischemic bowel in patients with incarcerated hernias
Authors: J. A. Keeley
A. Kaji
D. Y. Kim
B. Putnam
A. Neville
Publication date: 01-04-2019
Publisher: Springer Paris
Keywords: Soft Tissue Infection
Hyponatremia
Published in: Hernia / Issue 2/2019
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-019-01884-1

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Predictors of ischemic bowel in patients with incarcerated hernias

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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