Bowel obstruction epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Overview

The incidence of bowel obstruction in the US is 1.47 per 100,000 per year. Colorectal cancer and Crohn's disease are often complicated by bowel obstruction. The mortality rate is about 4 per 100,000 on average with the mortality rate reaching as high as 60 per 100,000 in the presence of bowel ischemia or when surgery is delayed. Bowel obstruction incidence has a median age of approximately 64 years. The incidence in newborns is about 1 in 2000 live births and 1 in 5000 in children above the age of 2. There is no racial predilection in cases of bowel obstruction. Men and women have an equal incidence of bowel obstruction. The highest incidence of bowel obstruction is found in the continent of Africa.

Epidemiology and Demographics

Incidence

  • The incidence of bowel obstruction is 1.47 per 100,000 per year in the United States.[1][2][3]
  • The incidence of large bowel obstruction is approximately 0.15 - 0.29 per 100,000 in patients with colorectal cancer.
  • It should be noted that 770 per 100,000 of surgical emergencies with colorectal carcinoma are attributed to bowel obstruction.
  • The incidence of bowel obstruction in cases of Crohn's disease may be as high as 250 per 100,000.

Prevalence

  • The prevalence of small bowel obstruction is approximately 100 - 500 per 100,000 - 5% in patients who have not undergone previous abdominal surgery.
  • The prevalence of small bowel obstruction is approximately 600 per 100,000 in patients who have undergone previous abdominal surgery.

Case-fatality rate/Mortality rate

The mortality rate of small bowel obstruction is approximately 4 per 100,000 and may reach 600 per 100,000 if bowel ischemia is present or if surgery is delayed.[4]

Age

  • The incidence of bowel obstruction increases with age; the median age at diagnosis is 64 years.[5]
  • The incidence of bowel obstruction in newborns is 1 in 2000 live births.[6][7]
  • The incidence of bowel obstruction in children after the first 2 years of life is 1 in 5000.

Race

There is no racial predilection to bowel obstruction.

Gender

Bowel obstruction affects men and women equally.[5]

Region

  • The majority of bowel obstruction cases are reported in Africa with an incidence of 12 per 100,000 per year.[8][9]
  • The incidence in the US and the UK is more rare with incidences of 1.47 per 100,000 per year and 1.7 per 100,000 per year respectively.

References

  1. Hill AG (2008). "The management of adhesive small bowel obstruction - an update". Int J Surg. 6 (1): 77–80. doi:10.1016/j.ijsu.2006.09.002. PMID 18359464.
  2. Jeong WK, Lim SB, Choi HS, Jeong SY (2008). "Conservative management of adhesive small bowel obstructions in patients previously operated on for primary colorectal cancer". J. Gastrointest. Surg. 12 (5): 926–32. doi:10.1007/s11605-007-0423-5. PMID 18060466.
  3. Attard JA, MacLean AR (2007). "Adhesive small bowel obstruction: epidemiology, biology and prevention". Can J Surg. 50 (4): 291–300. PMC 2386166. PMID 17897517.
  4. Zalcman M, Sy M, Donckier V, Closset J, Gansbeke DV (2000). "Helical CT signs in the diagnosis of intestinal ischemia in small-bowel obstruction". AJR Am J Roentgenol. 175 (6): 1601–7. doi:10.2214/ajr.175.6.1751601. PMID 11090385.
  5. 5.0 5.1 Drożdż W, Budzyński P (2012). "Change in mechanical bowel obstruction demographic and etiological patterns during the past century: observations from one health care institution". Arch Surg. 147 (2): 175–80. doi:10.1001/archsurg.2011.970. PMID 22351915.
  6. Tsao KJ, St Peter SD, Valusek PA, Keckler SJ, Sharp S, Holcomb GW, Snyder CL, Ostlie DJ (2007). "Adhesive small bowel obstruction after appendectomy in children: comparison between the laparoscopic and open approach". J. Pediatr. Surg. 42 (6): 939–42, discussion 942. doi:10.1016/j.jpedsurg.2007.01.025. PMID 17560198.
  7. Duron JJ, Silva NJ, du Montcel ST, Berger A, Muscari F, Hennet H, Veyrieres M, Hay JM (2006). "Adhesive postoperative small bowel obstruction: incidence and risk factors of recurrence after surgical treatment: a multicenter prospective study". Ann. Surg. 244 (5): 750–7. doi:10.1097/01.sla.0000225097.60142.68. PMC 1856591. PMID 17060768.
  8. Ballantyne GH, Brandner MD, Beart RW, Ilstrup DM (1985). "Volvulus of the colon. Incidence and mortality". Ann. Surg. 202 (1): 83–92. PMC 1250842. PMID 4015215.
  9. Raveenthiran V, Madiba TE, Atamanalp SS, De U (2010). "Volvulus of the sigmoid colon". Colorectal Dis. 12 (7 Online): e1–17. doi:10.1111/j.1463-1318.2010.02262.x. PMID 20236153.

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