title: [Acute small bowel obstruction: conservative or surgical treatment?].
abstract: Small bowel obstruction (SBO) is a common clinical syndrome caused mainly by postoperative adhesions. In complement to clinical and biological evaluations, CT scan has emerged as a valuable imaging modality and may provide reliable information. The early recognition of signs suggesting bowel ischemia is essential for urgent operation. However appropriate management of SBO remains a common clinical challenge. Although a conservative approach can be successful in a substantial percentage of selected patients, regular and close re-assessement is mandatory. Any persistance or progression of the critical symptoms and signs should indeed lead to surgical exploration. Here we review the principles of adhesive SBO management and suggest a decision procedure for conservative versus surgical treatment.
authors.affiliation: Service de chirurgie viscérale et de transplantation, Département de chirurgie, HUG, Genève 14. frank.schwenter@hcuge.ch
authors.forename: F
authors.initials: F
authors.lastname: Schwenter
authors.forename: S
authors.initials: S
authors.lastname: Dominguez
authors.forename: R
authors.initials: R
authors.lastname: Meier
authors.forename: W
authors.initials: W
authors.lastname: Oulhaci-de Saussure
authors.forename: A
authors.initials: A
authors.lastname: Platon
authors.forename: P
authors.initials: P
authors.lastname: Gervaz
authors.forename: P
authors.initials: P
authors.lastname: Morel
mesh_terms: D000208:Acute Disease; D000465:Algorithms; D042241:Early Diagnosis; D005440:Fluid Therapy / Q000379:methods; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D007421:Intestine, Small / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D000267:Tissue Adhesions / Q000601:surgery; D016896:Treatment Outcome