title: Manual Physical Therapy for Non-Surgical Treatment of Adhesion-Related Small Bowel Obstructions: Two Case Reports.
abstract: BACKGROUND
  Adhesion formation is a widely acknowledged risk following abdominal or pelvic surgery. Adhesions in the abdomen or pelvis can cause or contribute to partial or total small bowel obstruction (SBO). These adhesions deter or prevent the passage of nutrients through the digestive tract, and may bind the bowel to the peritoneum, or other organs. Small bowel obstructions can quickly become life-threatening, requiring immediate surgery to resect the bowel, or lyse any adhesions the surgeon can safely access. Bowel repair is an invasive surgery, with risks including bowel rupture, infection, and peritonitis. An additional risk includes the formation of new adhesions during the healing process, creating the potential for subsequent adhesiolysis or SBO surgeries.
  
  
  OBJECTIVE
  Report the use of manual soft tissue physical therapy for the reversal of adhesion-related partial SBOs, and create an initial inquiry into the possibility of nonsurgical lysis of adhesions.
  
  
  METHODS
  Two patients presenting with SBO symptoms due to abdominal adhesions secondary to abdominal and pelvic surgery were treated with manual soft tissue physical therapy focused on decreasing adhesions.
  
  
  CONCLUSIONS
  Successful treatment with resolution of symptom presentation of partial SBO and sustained results were observed in both patients treated.
authors.affiliation: Clear Passage Physical Therapy, 4421 NW 39th Ave, Ste 2-2, Gainesville, FL 32606, USA. amandar@clearpassage.com.
authors.forename: Amanda D
authors.initials: AD
authors.lastname: Rice
authors.affiliation: Clear Passage Physical Therapy, 4421 NW 39th Ave, Ste 2-2, Gainesville, FL 32606, USA. richardk@clearpassage.com.
authors.forename: Richard
authors.initials: R
authors.lastname: King
authors.affiliation: Clear Passage Physical Therapy, 4421 NW 39th Ave, Ste 2-2, Gainesville, FL 32606, USA. evetter@clearpassage.com.
authors.forename: Evette D'Avy
authors.initials: ED
authors.lastname: Reed
authors.affiliation: Clear Passage Physical Therapy, 4421 NW 39th Ave, Ste 2-2, Gainesville, FL 32606, USA. kimp@clearpassage.com.
authors.forename: Kimberley
authors.initials: K
authors.lastname: Patterson
authors.affiliation: Clear Passage Physical Therapy, 4421 NW 39th Ave, Ste 2-2, Gainesville, FL 32606, USA. belindaw@clearpassage.com.
authors.forename: Belinda F
authors.initials: BF
authors.lastname: Wurn
authors.affiliation: Clear Passage Physical Therapy, 4421 NW 39th Ave, Ste 2-2, Gainesville, FL 32606, USA. larryw@clearpassage.com.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Wurn
keywords: SBO treatment; manual physical therapy; small bowel obstruction; surgery alternative