Early postoperative small bowel obstruction

The hospital records of 41 patients with a diagnosis of early postoperative small bowel obstruction were reviewed in an attempt to identify criteria which could be used to separate those patients who would require an operation to resolve their obstruction, from those who would resolve with nonoperative therapy. The usual symptoms, signs and roentgenologic changes seen with mechanical bowel obstruction were not useful discriminants in making such a determination. All patients were initially treated nonoperatively with intestinal intubation, antibiotics and parenteral fluids. Thirty patients resolved without an operation and 11 required an operation. There was one death in the latter group, an overall mortality of 2.4%. Initial nonoperative therapy is warranted in such patients.