Evaluation of Treatment Modalities of the Adhesive Small Bowel Obstruction

Abstract Background: Intestinal obstruction (IO) is one of the common serious surgical emergencies. The most common causes of it are adhesions and hernias. Unlike most other causes of IO, there is an important role for conservative treatment in the management of adhesive intestinal obstruction (ASBO). Objectives: To assess the causes and types of surgery that lead to (ASBO) and to assess the role of conservative treatment in the management (ASBO). Materials and Methods: A retrospective study was conducted over a period of four years. Out of 164 patients with SBO, in 92 patients, adhesion was the cause of obstruction (56%), hernia in 66 patients (40.2%), and miscellaneous causes in 3.8%. Results: In total, 78 patients (84.7%) had a simple obstruction, and 14 patients (15.2%) had strangulated obstruction. The leading causes of ASBO are previous laparotomy for abdominal trauma (28.2%), appendectomy (21.7%), and gastrointestinal surgery (20.6%). The conservative treatment was successful in 68% in a mean period of 2 days; hospitalization was shorter in comparison with the operative group. Recurrent ASBO cases were successfully treated conservatively. The overall mortality rate was 4.3% (4.7% in the operative group and 4% in the conservatively treated group). Conclusion: In our study, ASBO is the most common cause of IO. Abdominal trauma followed by appendectomies operations are the most common causes of adhesions. There is an important role of conservative treatment in the management of ASBO, with a success rate of 68%.