Postlaparoscopic small bowel obstruction. Rethinking its management.
BACKGROUND
Patients with early postoperative small bowel obstruction (SBO) are usually managed nonoperatively with nasogastric suction, intravenous fluids, and observation. The majority of early postoperative SBO resolve without an operation.


METHODS
We performed a retrospective review of patients who had been diagnosed with postlaparoscopic SBO at three Chicago area teaching hospitals.


RESULTS
The patients were initially managed nonoperatively for up to 7 days. However, all of them subsequently required an operation. In every case, the postlaparoscopic SBO was caused by the small bowel being incarcerated in a peritoneal defect created either by trocar placement or peritoneal incision for herniorrhaphy.


CONCLUSIONS
In contradistinction to the approach used for early SBO after laparotomy, prompt operative intervention for postlaparoscopic SBO is recommended.
Department of Surgery, Rush University, Skokie, IL, USA.
J M
JM
Velasco
V L
VL
Vallina
S R
SR
Bonomo
T J
TJ
Hieken
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D007415:Intestinal Obstruction / Q000453:epidemiology / Q000209:etiology*; D007421:Intestine, Small; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies