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Prediction of bowel obstruction caused by obturator hernia using risk factor categories on clinical characteristics and multidetector computed tomographic findings

  • Special Section: The pelvic floor
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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To detect risk factors on clinical characteristics and multidetector computed tomographic (MDCT) findings for predicting bowel obstruction in patients with obturator hernia.

Methods

We retrospectively reviewed 47 patients who had an obturator hernia diagnosed by MDCT and/or surgery. The patients were divided into obstruction and non-obstruction group based on the presence or absence of bowel obstruction on MDCT images. Uni- and multivariate analyses were performed to identify risk factors for predicting bowel obstruction.

Results

There were 26 patients (55.32%) in the obstruction group and 21 patients (44.68%) in the non-obstruction group. Patients in the obstruction group were older (P = 0.002) and had more women (P = 0.033) and lower body mass index (BMI) (P = 0.0001) than patients in the non-obstruction group. The non-obstruction group suffered fewer bowel obstruction symptoms (P = 0.0001), Howship-Romberg (HR) sign (P = 0.012), deaths (P = 0.008) and major postoperative complications (P = 0.047). The hernia sac in the obstruction group had greater mean major diameter (P = 0.0001) and volume (P = 0.001) than those in the non-obstruction group. Multivariate analysis showed that age [odds ratio (OR) 1.18, 95% confidence interval (CI) 1.00–1.39, P = 0.046] and major diameter of hernia sac (OR 68.17, 95% CI 4.52–1027.70, P = 0.002) were independent risk factors associated with bowel obstruction in patients with obturator hernia.

Conclusions

Patient’s age and major diameter of hernia sac are independent risk factors resulting in bowel obstruction in patients with obturator hernia. Obturator hernia repair before bowel obstruction development may result in better outcomes and fewer postoperative complications.

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Abbreviations

MDCT:

Multidetector computed tomography

CT:

Computed tomography

BMI:

Body mass index

HR:

Howship–Romberg

PPMVG:

Pneumatosis and/or portomesenteric venous gas

OR:

Odds ratio

CI:

Confidence interval

PFDs:

Pelvic floor disorders

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Acknowledgements

The authors thank pathology staff Hua-liang Xiao, computed tomography technician Qi-sheng Ran and Guang-kuo Guo for their help.

Funding

This study was supported by Grants from the National Natural Science Foundation of China (81671943).

Author information

Author notes

  1. Jing Zhang and Chun-lai Zhang contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China

    Jing Zhang, Chun-lai Zhang, Xiao-guang Li & Yi Wang

  2. Department of Radiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China

    Lian-qin Kuang

  3. Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, China

    Wei Tang

Authors
  1. Jing Zhang
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  2. Chun-lai Zhang
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  3. Lian-qin Kuang
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  4. Xiao-guang Li
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  5. Wei Tang
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  6. Yi Wang
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Correspondence to Yi Wang.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the ethics board of our institution and the requirement to obtain informed consent was waived because of the retrospective design.

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Zhang, J., Zhang, Cl., Kuang, Lq. et al. Prediction of bowel obstruction caused by obturator hernia using risk factor categories on clinical characteristics and multidetector computed tomographic findings. Abdom Radiol 46, 4069–4078 (2021). https://doi.org/10.1007/s00261-020-02838-3

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  • DOI: https://doi.org/10.1007/s00261-020-02838-3

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