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April 1974

Acute Large Bowel Obstruction: Comparison of County, Veterans Administration, and Community Hospital Populations

Author Affiliations

Hines, Ill; Blue Island, Ill; Evanston, Ill; Maywood, Ill
From the departments of surgery, Loyola University Affiliated Hospitals: Foster G. McGaw Hospital, Maywood, Ill (Drs. Banich and Freeark), Veterans Administration Hospital, Hines, Ill (Drs. Greenlee and Pienkos); and St. Francis Hospital, Blue Island, Ill (Dr. Vanderbilt); and Cook County Hospital, Chicago.

Arch Surg. 1974;108(4):470-476. doi:10.1001/archsurg.1974.01350280076013

Three hundred patients with large bowel obstruction were treated by emergency operation in a county, Veterans Administration, and community hospital population. Primary carcinoma of the colon, volvulus, and diverticulitis were the etiological factors in 84% of the patients. The combined hospital mortality of 37% was distributed as follows: county, 42%; VA, 40%; and community, 30%. Mortality from obstructing carcinoma was similar in all institutions. This was apparently related to the frequent insidious onset. In contrast, the community hospital had a decided edge in the successful management of volvulus and obstructing diverticulitis. The more dramatic onset of these two diseases prompted the private patient to seek medical consultation earlier.