{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T03:33:53Z","timestamp":1791603233282,"version":"4.3.4"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T00:00:00Z","timestamp":1673913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T00:00:00Z","timestamp":1673913600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T00:00:00Z","timestamp":1673913600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Identifying the 30% of adhesive small bowel obstructions (aSBO) for which conservative management will require surgery is essential. The association between the previously described radiological score and failure of the conservative management of aSBO remains to be confirmed in a large prospective multicentric cohort. Our aim was to assess the risk factors of failure of the conservative management of aSBO considering the radiological score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>This prospective observational study took place in 15 French centers over 3\u00a0months. Consecutive patients experiencing aSBO with no early surgery were included. The six radiological features from the Angers radiological computed tomography (CT) score were noted (beak sign, closed loop, focal or diffuse intraperitoneal liquid, focal or diffuse mesenteric haziness, focal or diffuse mesenteric liquid, and diameter of the most dilated small bowel loop\u2009&gt;\u200940\u00a0mm).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred and seventy nine patients with aSBO were screened. Sixty patients (21.5%) underwent early surgery, and 219 (78.5%) had primary conservative management. In the end, 218 patients were included in the analysis of the risk factors for conservative treatment failure. Among them, 162 (74.3%) had had successful management while for 56 (25.7%) management had failed. In multivariate analysis, a history of surgery was not a significant risk factor for the failure of conservative treatment (OR\u2009=\u20090.11; 95%CI\u2009=\u20090\u20131.23). A previous episode of aSBO was protective against the failure of conservative treatment (OR\u2009=\u20090.36; 95%CI\u2009=\u20090.15\u20130.85) and an Angers CT score\u2009\u2265\u20095 as the only individual risk factor (OR\u2009=\u20092.39; 95%CI\u2009=\u20091.01\u20135.69).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The radiological score of aSBO is a promising tool in improving the management of aSBO patients. A first episode of aSBO and\/or a radiological score\u2009\u22655 should lead physicians to consider early surgical management.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-023-06906-9","type":"journal-article","created":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T13:03:22Z","timestamp":1673960602000},"page":"975-984","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["The Angers CT Score is a Risk Factor for the Failure of the Conservative Management of Adhesive Small Bowel Obstruction: A Prospective Observational Multicentric Study"],"prefix":"10.1002","volume":"47","author":[{"given":"Anita","family":"Paisant","sequence":"first","affiliation":[{"name":"Laboratoire HIFIH, EA3859 UNIV Angers Angers France"},{"name":"Department of Radiology Angers University Hospital 49933 Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne","family":"Burgmaier","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Digestive Surgery University Hospital of Rennes Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Calame","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Bourgogne Franche\u2010Comt\u00e9, CHU Besan\u00e7on Besan\u00e7on France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e9lanie","family":"Loison","sequence":"additional","affiliation":[{"name":"Department of Digestive and Endocrinal Surgery Angers University Hospital 49933 Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Moli\u00e8re","sequence":"additional","affiliation":[{"name":"Department of Radiology University Hospital of Strasbourg Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Brigand","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery University Hospital of Strasbourg Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dihia","family":"Belabbas","sequence":"additional","affiliation":[{"name":"Department of Radiology University Hospital of Rennes Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Duchalais","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery University Hospital of Nantes, Institut des Maladies de l'Appareil Digestif Nantes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Marc","family":"Regimbeau","sequence":"additional","affiliation":[{"name":"Service de Chirurgie Digestive CHU Amiens Picardie Et Universit\u00e9 de Picardie Jules Verne Amiens France"},{"name":"Unit\u00e9 de Recherche Clinique SSPC (Simplifications Des Soins Des Patients Complexes) UR UPJV 7518 Universit\u00e9 de Picardie Jules Verne Amiens France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Yzet","sequence":"additional","affiliation":[{"name":"Service de Radiologie CHU Amiens Picardie Et Universit\u00e9 de Picardie Jules Verne Amiens France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Alves","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery University Hospital of Caen Avenue de La C\u00f4te de Nacre 14033 Caen Cedex France"},{"name":"UMR INSERM U1086 Anticipe Centre Fran\u00e7ois Baclesse, Avenue du G\u00e9n\u00e9ral Harris 14045 Caen Cedex France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Fohlen","sequence":"additional","affiliation":[{"name":"Department of Radiology University Hospital of Caen Caen 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December 2022","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 January 2023","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest related to the present work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study has been approved by our local research ethics committee (Number 2021\/099).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All patients were informed that their data could be used for medical research and were asked to indicate if they did not agree with that use. None of the patients signified their disagreement.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}