Signs and Evidence

Making clinical sense of scientific data

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Small bowel obstruction

Calculated pretest-probability: 0.7 %
Relevant inclusion criteria: Acute abdominal pain Calculate probabilities!

Clinical signs

Constipation
 Positive likelihood ratio
8.80 ( Bohner H et al. )
(average) 8.80
Negative likelihood ratio
0.60 ( Bohner H et al. )
(average) 0.6
Rebound tenderness
 Positive likelihood ratio
5.10 ( Bohner H et al. )
(average) 5.10
Negative likelihood ratio
0.70 ( Bohner H et al. )
(average) 0.7
Bowel sounds increased
 Positive likelihood ratio
3.50 ( Bohner H et al. )
(average) 3.50
Negative likelihood ratio
0.70 ( Bohner H et al. )
(average) 0.7
Bowel sound decreased
 Positive likelihood ratio
3.20 ( Bohner H et al. )
(average) 3.20
Negative likelihood ratio
0.80 ( Bohner H et al. )
(average) 0.8
Abdominal pain
 Positive likelihood ratio
2.90 ( Bohner H et al. )
(average) 2.90
Negative likelihood ratio
0.80 ( Bohner H et al. )
(average) 0.8
Abdominal Mass
 Positive likelihood ratio
2.20 ( Bohner H et al. )
(average) 2.20
Negative likelihood ratio
0.90 ( Bohner H et al. )
(average) 0.9
Vomiting
 Positive likelihood ratio
2.20 ( Bohner H et al. )
(average) 2.20
Negative likelihood ratio
0.40 ( Bohner H et al. )
(average) 0.4

Sources used:

1.Bohner H et al. Simple data from history and physical examination help to exclude bowel obstruction and to avoid radiographic studies in patients with acute abdominal pain. Eur J Surg. 1998 Oct;164(10):777-84
2.Cervellin G et al. Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases. Ann Transl Med. 2016 Oct; 4(19): 362