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Small bowel obstruction and its management.

H J Asbun1, C Pempinello, N A Halasz

  • 1Department of Surgery, Veterans Administration Medical Center, San Diego, California.

International Surgery
|January 1, 1989
PubMed
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Small bowel obstruction (SBO) is often caused by adhesions from prior surgery. Fever and leukocytosis predict longer hospital stays, while conservative management is effective for many SBO cases.

Area of Science:

  • Gastroenterology
  • Surgical Outcomes
  • Abdominal Surgery

Background:

  • Small bowel obstruction (SBO) is a common surgical emergency.
  • Adhesions are the leading cause of SBO, often resulting from previous abdominal surgeries.
  • Malignancy is another significant etiology for SBO.

Purpose of the Study:

  • To analyze the causes, clinical presentation, management, and outcomes of small bowel obstruction.
  • To identify predictors of prolonged hospital stay, morbidity, and mortality in SBO patients.
  • To compare outcomes between conservative and surgical management of SBO.

Main Methods:

  • Retrospective analysis of 105 cases of SBO in 80 patients over a ten-year period.
  • Review of patient demographics, surgical history, clinical signs, management strategies, and outcomes.

Related Experiment Videos

  • Statistical analysis to identify correlations between clinical factors and outcomes.

    • Main Results:

    • Adhesions accounted for 73% of SBO cases, with appendectomy and pelvic procedures being common antecedents.
    • Fever (>100°F) was associated with increased morbidity, mortality, strangulation, and prolonged hospital stay.
    • Conservative management was successful in 45% of cases; surgical management was required for 55%.
    • Overall morbidity was 21% and mortality was 3.8%, with malignancy being the leading cause of death.
    • For adhesive SBO, conservative treatment resulted in a shorter hospital stay (8.5 days) and lower morbidity (5%) compared to surgical treatment (16.5 days, 32% morbidity).

    Conclusions:

    • Adhesions are the primary cause of SBO, frequently linked to appendectomy and pelvic surgeries.
    • Fever and leukocytosis are important indicators of severe SBO and predict worse outcomes.
    • Conservative management is a viable option for a significant proportion of SBO cases, offering better outcomes than surgery when feasible.