title: Acute mechanical intestinal obstructions.
abstract: BACKGROUND
  In this study, we evaluated our treatment modality and timing of surgery in acute mechanical intestinal obstruction (AMIO) patients who were admitted to the emergency room.
  
  
  METHODS
  Only patients with the diagnosis of AMIO were included in this study. Surgery was performed in patients with hemodynamic instability despite fluid resuscitation and peritoneal signs upon physical examination. Patients were divided into two groups. Adhesion cases were assigned to Group 1, while non-adhesion cases were assigned to Group 2. The decision to provide surgical or medical therapy was assessed 24 hours (h) after admission.
  
  
  RESULTS
  Twenty-two patients in Group 1 and 53 patients in Group 2 underwent surgical procedures. The difference between the groups was statistically different (p < 0.05). The mean monitoring time after admission to the hospital was 128.3 +/- 24.85 h and 43.1 +/- 15.51 h in Groups 1 and 2, respectively (p = 0.0001). In Group 2, 76.6% of the patients who were monitored for over 24 hours required surgery. In contrast, this rate was only 36% in Group 1 (p < 0.05).
  
  
  CONCLUSIONS
  Our clinical experience shows that medical therapy and monitoring over 24 hours is not a good substitute for surgical treatment of AMIO when the obstruction is not due to an adhesion.
authors.affiliation: 3rd Department of General Surgery, Kartal Training and Research Hospital, Istanbul, Turkey. hfkucuk@gmail.com
authors.forename: Hasan Fehmi
authors.initials: HF
authors.lastname: Küçük
authors.forename: Hasan Ediz
authors.initials: HE
authors.lastname: Sikar
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Uzun
authors.forename: Firat
authors.initials: F
authors.lastname: Tutal
authors.forename: Levent
authors.initials: L
authors.lastname: Kaptanoğlu
authors.forename: Necmi
authors.initials: N
authors.lastname: Kurt
mesh_terms: D000038:Abscess / Q000453:epidemiology; D000208:Acute Disease; D005260:Female; D005402:Fistula / Q000453:epidemiology; D006801:Humans; D007239:Infections / Q000453:epidemiology; D007415:Intestinal Obstruction / Q000188:drug therapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification / Q000601:surgery; D011446:Prospective Studies; D013529:Surgical Wound Dehiscence / Q000453:epidemiology