Success rate and associated factors of conservative management of adhesive small bowel obstruction at Dessie comprehensive specialized hospital, Northeast Ethiopia

Small bowel obstructions (SBOs) account for about a fourth of hospital admissions related to acute abdominal complaints. Adhesive small bowel obstruction (ASBO) is the most common cause of SBO worldwide, and there are reported high success rates for conservative management. Understanding the success rate of conservative management in the Ethiopian context and the factors that influence it is crucial to prevent unnecessary surgeries and delays in treatment. To determine how often non-surgical treatment works for adhesive small bowel obstruction and to identify the factors that influence its success at Dessie Comprehensive Specialized Hospital, Ethiopia, between 2021 and 2023. A retrospective chart review was conducted on 350 ASBO cases at Dessie Comprehensive Specialized Hospital from June 1, 2021, to July 30, 2023. Cases were selected to represent each year of the study period, and patient charts were chosen randomly. Information from the records was compiled and analyzed to explore factors linked to patient outcomes. Associations between these factors and treatment results were examined, and findings were considered significant when the evidence strongly suggested a real relationship. The study included 350 ASBO cases, with a conservative management success rate of 45.1% (158 cases). Success was linked to factors like previous similar illnesses (AOR = 0.143), obstipation (AOR = 0.002), and the duration of current illness: <24 h (AOR = 0.143), 24-48 h (AOR = 9.250), and 48-72 h (AOR = 0.005). Additionally, the timing of the index operation influenced success: <1 month (AOR = 21.80), 1-3 years (AOR = 6.541), and 3-10 years (AOR = 31.997). The success rate of conservative management is higher than that reported in a similar local study; however, it remains low compared to global studies. Factors significantly associated with the success rate include the presence of previous episodes of illness, the duration of the current illness, the timing of the index operation, the presence of obstipation, and the length of the conservative management period.