[Acute small bowel obstruction: conservative or surgical treatment?]

Area of Science:

• Gastroenterology
• Abdominal Surgery
• Radiology

Context:

• Small bowel obstruction (SBO) is a frequent clinical condition, predominantly resulting from postoperative adhesions.
• Accurate diagnosis and timely intervention are crucial for managing SBO, particularly when bowel ischemia is suspected.
• CT scans offer valuable insights complementing clinical and biological assessments in SBO evaluation.

Purpose:

• To review the management principles of adhesive SBO.
• To present a decision-making framework for selecting between conservative and surgical treatment strategies for SBO.
• To emphasize the importance of early recognition of bowel ischemia in SBO management.

Summary:

• Adhesive SBO necessitates a thorough evaluation, with CT scans playing a key role in assessing severity and guiding treatment.
• A conservative approach may be suitable for select patients, but requires vigilant monitoring for symptom progression.
• Persistent or worsening critical signs and symptoms mandate surgical intervention to prevent complications.

Impact:

• This review provides a structured approach to SBO management, potentially improving clinical decision-making.
• Enhanced understanding of SBO principles can lead to more appropriate and timely treatment selection, optimizing patient outcomes.
• The proposed decision procedure aims to reduce diagnostic delays and ensure effective management of this common surgical challenge.