title: Management of ileus and small-bowel obstruction following benign gynecologic surgery.
abstract: OBJECTIVE
  To describe practice preferences for the diagnosis and management of ileus and small-bowel obstruction (SBO) following benign gynecologic surgery.
  
  
  METHODS
  A secondary descriptive analysis was performed on data from a multicenter case-control study of patients who underwent gynecologic surgery and subsequently developed ileus or SBO. Information was collected regarding interventions such as type of imaging ordered for diagnosis, diet alterations, antiemetic administration, and need for reoperation.
  
  
  RESULTS
  In total, 144 cases were identified. Abdominal X-ray was the most common imaging modality, occurring in 54 (37.5%) cases. Sixty-nine (65.1%) of the 106 women who underwent imaging were given definitive radiologic diagnoses of either ileus (50 [72.5%]) or SBO (19 [27.5%]); 57.9% (n=11) of the SBO diagnoses and 90.0% (n=45) of the ileus diagnoses were managed conservatively. Eighteen (12.5%) patients underwent reoperation for bowel obstruction. There were no significant differences in rate of reoperation between cases involving the use of single antiemetics and those involving the use of multiple antiemetics (P=0.18), or between diet statuses on postoperative day 1 (P=0.08).
  
  
  CONCLUSIONS
  Most study centers initially performed an abdominal X-ray for diagnostic purposes. The majority used a multimodal treatment approach. None of the management options decreased the likelihood of reoperation.
authors: Division of Female Pelvic Medicine and Reconstructive Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, USA. arielle.allen@integris-health.com
authors: Arielle M
authors: AM
authors: Allen
authors: Danielle D
authors: DD
authors: Antosh
authors: Cara L
authors: CL
authors: Grimes
authors: Catrina C
authors: CC
authors: Crisp
authors: Aimee L
authors: AL
authors: Smith
authors: Sarah
authors: S
authors: Friedman
authors: Brook L
authors: BL
authors: McFadden
authors: Robert E
authors: RE
authors: Gutman
authors: Rebecca G
authors: RG
authors: Rogers
mesh_terms: D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use; D016022:Case-Control Studies; D004359:Drug Therapy, Combination; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D045823:Ileus / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D007421:Intestine, Small / Q000473:pathology; D011183:Postoperative Complications; D011860:Radiography, Abdominal / Q000379:methods; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies
chemical_list: D000932:Antiemetics