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Small Bowel Obstruction.

Joshua M. Cooper1, Richard C. Thirlby

  • 1Department of Surgery, Virginia Mason Medical Center, 1100 Ninth Avenue, C6-SUR,Seattle, Washington 98101, USA. richard.thirlby@vmmc.org

Current Treatment Options in Gastroenterology
|January 17, 2002
PubMed
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Optimal treatment for small bowel obstruction (SBO) requires diagnosing mechanical obstruction versus ileus, identifying causes, and assessing completeness and strangulation. Prompt surgical intervention is crucial for complete SBO due to adhesions.

Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology
  • Abdominal Imaging

Background:

  • Small bowel obstruction (SBO) is a common surgical emergency.
  • Accurate diagnosis is critical for timely and appropriate management.
  • Adhesions are a leading cause of SBO in developed countries.

Purpose of the Study:

  • To outline the key diagnostic questions for managing small bowel obstruction.
  • To emphasize the role of clinical evaluation and CT scanning.
  • To define the optimal timing for surgical intervention in SBO.

Main Methods:

  • Review of diagnostic criteria for small bowel obstruction.
  • Emphasis on history, physical examination, laboratory tests, and CT scanning.
  • Analysis of treatment pathways based on obstruction characteristics.

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Main Results:

  • Key diagnostic questions include differentiating mechanical obstruction from ileus, identifying the cause, determining partial vs. complete obstruction, and assessing for strangulation.
  • CT scanning is highlighted as an efficient diagnostic tool.
  • Surgical intervention within 48 hours is recommended for complete SBO from adhesions.

Conclusions:

  • A systematic diagnostic approach is essential for effective small bowel obstruction management.
  • Early surgical intervention is indicated for complete SBO due to adhesions.
  • Endoscopic treatment for SBO is considered unlikely to be durable.