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Intestinal intubation in acute, mechanical small-bowel obstruction
Archives of Surgery (Chicago, Ill. : 1960)
|March 1, 1982
Summary
Nonoperative intestinal intubation effectively treats partial small-bowel obstruction. While complete obstruction often requires surgery, a 24-hour delay with intubation did not increase patient morbidity or mortality.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
Background:
- Small-bowel obstruction (SBO) is a common surgical emergency.
- Adhesions are the leading cause of SBO.
- Nonoperative management with intestinal intubation is an option for SBO.
Purpose of the Study:
- To evaluate the efficacy and safety of nonoperative intestinal intubation for SBO.
- To determine outcomes for patients with partial and complete SBO treated nonoperatively.
Main Methods:
- Retrospective review of 100 consecutive patients with SBO due to adhesions.
- Patients were treated with nonoperative intestinal intubation for at least 24 hours.
- Outcomes including need for surgery, morbidity, and mortality were analyzed.
Main Results:
- 65% of partial SBO patients were successfully treated without surgery.
- 25% of complete SBO patients were safely treated nonoperatively.
- A 24-hour delay for surgery in complete SBO did not increase morbidity or mortality.
- Antibiotic use reduced wound infections in surgical patients.
Conclusions:
- Nonoperative intestinal intubation is a safe and effective treatment for partial SBO.
- Nonoperative management can be considered for select complete SBO cases.
- Early surgical intervention is indicated for suspected strangulation or persistent obstruction.