Adhesive small bowel obstruction: how long can patients tolerate conservative treatment?
OBJECTIVE
To evaluate how long patients with small bowel obstruction caused by postoperative adhesions can tolerate conservative treatment.


METHODS
The records of patients with small bowel obstruction due to postoperative adhesions were retrospectively reviewed. Data collected included the number of admissions, type of management for each admission, duration of conservative treatment, number of repeat laparotomies, and operative findings.


RESULTS
One hundred fifty-five patients with this condition from January 1999 to December 2001, for a total of 293 admissions were enrolled in this study. Medical treatment alone was given in 220 admissions, and repeat laparotomy was performed in 73 admissions. The period of observation in patients managed medically ranged from 2 to 12 days (average: 6.9 days), while for those who underwent surgery, the range was 1 to 14 days (average 5.4 days). At surgery, adhesions were the only finding in 46 cases, while there were intestinal complications in 27, or 9.2 % of all 293 admissions. Fever and leukocytosis greater than 15 000/mm(3) were prediction of intestinal complications.


CONCLUSIONS
With closely monitoring, most patients with small bowel obstruction due to postoperative adhesions could tolerate supportive treatment and recover well averagely within 1 week, although some patients require more than 10 days of observation.
Shih
Shou-Chuan
SC
Gastroenterology Section, Department of Internal Medicine, Mackay Memorial Hospital and Mackay Junior College of Nursing, No. 92, section 2, Chang-San North Road, Taipei, Taiwan, China. sschuan@ms2.mmh.org.tw
Jeng
Kuo-Shyang
KS
Lin
Shee-Chan
SC
Kao
Chin-Roa
CR
Chou
Sun-Yen
SY
Wang
Horng-Yuan
HY
Chang
Wen-Hsiung
WH
Chu
Cheng-Hsin
CH
Wang
Tsang-En
TE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications*; D007415:Intestinal Obstruction / Q000209:etiology* / Q000628:therapy*; D007421:Intestine, Small; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D000267:Tissue Adhesions / Q000150:complications