Partial small bowel obstruction

From January 1976 through December 1980, 91 patients were admitted to Middlesex General Hospital in New Brunswick, N.J. with an initial diagnosis of partial small bowel obstruction. Postoperative adhesions accounted for 79% of the cases. Eighty of the 91 patients (88%) were managed successfully by tube decompression with 67 (74%) showing clinical or radiographic improvement within the first 24 hours. The mean duration of hospitalization for the nonoperative group was 6.9 days, 5.3 days for patients managed with nasogastric tubes versus 10.8 days for those managed with long tubes (P less than or equal to 0.008). Of the 11 patients who required operation, the mean preoperative hospital stay was 7.7 days, and four patients suffered nonfatal postoperative complications. None of the 91 patients developed strangulation. A barium upper gastrointestinal series was performed in 13 cases and was reliable in the determination of the need for operative intervention in each case. More efficient treatment of partial small bowel obstruction can be accomplished with a nasogastric tube as opposed to a long tube and by earlier use of barium upper gastrointestinal contrast studies in cases that do not resolve after 48 hours of tube decompression.