Small Bowel Obstruction: Likelihood Ratios

Introduction: None written.

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The likelihood ratios of findings for Small Bowel Obstruction are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Good Negative Likelihood Ratio
Finding	Result	+LR	-LR
[ + ] Abdominal X-Ray	+ 0 -	1.6	0.5
many sources list sensitivity closer to 50% Study: Am Surg. 1999 Oct;65(10):922-6. PMID: 10515535

Poorly Diagnostic Findings
Finding	Result	+LR	-LR
[ + ] Elevated D-dimer	+ 0 -	1.9	0.6
for strangulated SBO Study: Medicina (Kaunas). 2007;43(11):850-4. PMID: 18084141

Findings With Unspecified Accuracy
Finding	Result	+LR	-LR
[ + ] Elevated Serum Amylase		No accuracy specified.
Study: no study specified.
[ + ] hearing loss		No accuracy specified.
Study: no study specified.
[ + ] Tachycardia		No accuracy specified.
Study: no study specified.
[ + ] Leukocytosis		No accuracy specified.
Study: no study specified.
[ + ] UGI/SBFT		No accuracy specified.
An upper GI and small bowel follow-through can differentiate between mechanical obstruction and an ileus Study: no study specified.

Good Positive and Negative Likelihood Ratios
Finding	Result	+LR	-LR
[ + ] Enteroclysis	+ 0 -	8.3	0
plain film enteroclysis Study: Radiol Clin North Am. 2003 Mar;41(2):263-83, vi. PMID: 12659338
[ + ] CT Enteroclysis	+ 0 -	inf	0.1
Study: Radiology. 2007 Dec;245(3):661-71. PMID: 18024448
[ + ] Elevated Serum Lactate	+ 0 -	6.9	0.1
for ischemia Study: Am J Surg 1994 Jun;167(6):575-8. PMID 8209931
[ + ] Abdominal US	+ 0 -	inf	0.2
Study: Acta Radiol 1999 Jul;40(4):422-8. PMID 10394872
[ + ] Abdominal CT	+ 0 -	3.8	0.2
non-enhanced Study: Eur J Radiol. 2009 Jul;71(1):135-40. PMID 18534800
[ + ] Abdominal CT	+ 0 -	3.5	0.2
with IV contrast Study: Eur J Radiol. 2009 Jul;71(1):135-40. PMID 18534800
[ + ] Clinical diagnosis	+ 0 -	75	0.3
Study: Scand J Gastroenterol. 1994 Aug;29(8):715-21 PMID: 7973431
[ + ] Abdominal Distension	+ 0 -	5.8	0.4
for SBO as final diagnosis of abdominal pain Study: Eur J Surg. 1998 Oct;164(10):777-84. PMID: 9840308
[ + ] History of Abdominal Surgery	+ 0 -	2.6	0.4
for SBO as final dx of abdominal pain Study: Eur J Surg. 1998 Oct;164(10):777-84. PMID: 9840308
[ + ] Emesis	+ 0 -	2.2	0.4
for SBO as final dx of abdominal pain Emesis is more common in proximal small bowel obstruction than in distal small bowel obstruction Study: Eur J Surg. 1998 Oct;164(10):777-84. PMID: 9840308
[ + ] Abdominal CT	+ 0 -	8.3	0.5
Study: Radiology. 2007 Dec;245(3):661-71. PMID: 18024448
[ + ] Age	+ 0 -	2.2	0.5
for SBO as final dx of abdominal pain Study: Eur J Surg. 1998 Oct;164(10):777-84. PMID: 9840308

Good Positive Likelihood Ratio
Finding	Result	+LR	-LR
[ + ] History of Constipation	+ 0 -	8.8	0.6
for SBO as final dx of abdominal pain Study: Eur J Surg. 1998 Oct;164(10):777-84. PMID: 9840308
[ + ] Abdominal Tenderness	+ 0 -	5.1	0.7
for SBO as final diagnosis of abdominal pain Study: Eur J Surg. 1998 Oct;164(10):777-84. PMID: 9840308
[ + ] Relief of Pain by Vomiting	+ 0 -	4.3	0.8
for SBO as final dx of abdominal pain Study: Eur J Surg. 1998 Oct;164(10):777-84. PMID: 9840308
[ + ] Increased Bowel Sounds	+ 0 -	3.5	0.7
Study: Eur J Surg. 1998 Oct;164(10):777-84. PMID: 9840308
[ + ] Decreased Bowel Sounds	+ 0 -	3.2	0.8
for SBO as final dx of abdominal pain Study: Eur J Surg. 1998 Oct;164(10):777-84. PMID: 9840308
[ + ] Colicky Pain	+ 0 -	2.9	0.8
for SBO as final dx of abdominal pain Study: Eur J Surg. 1998 Oct;164(10):777-84. PMID: 9840308
[ + ] Abdominal Rigidity	+ 0 -	2.7	0.9
for SBO as final dx of abdominal pain Study: Eur J Surg. 1998 Oct;164(10):777-84. PMID: 9840308
[ + ] Abdominal Mass	+ 0 -	2.2	0.9
for SBO as final diagnosis of abdominal pain Study: Eur J Surg. 1998 Oct;164(10):777-84. PMID: 9840308