title: Adhesive small bowel adhesions obstruction: Evolutions in diagnosis, management and prevention.
abstract: Intra-abdominal adhesions following abdominal surgery represent a major unsolved problem. They are the first cause of small bowel obstruction. Diagnosis is based on clinical evaluation, water-soluble contrast follow-through and computed tomography scan. For patients presenting no signs of strangulation, peritonitis or severe intestinal impairment there is good evidence to support non-operative management. Open surgery is the preferred method for the surgical treatment of adhesive small bowel obstruction, in case of suspected strangulation or after failed conservative management, but laparoscopy is gaining widespread acceptance especially in selected group of patients. "Good" surgical technique and anti-adhesive barriers are the main current concepts of adhesion prevention. We discuss current knowledge in modern diagnosis and evolving strategies for management and prevention that are leading to stratified care for patients.
authors.affiliation: Fausto Catena, Department of Emergency and Trauma Surgery, University Hospital of Parma, 43100 Parma, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Catena
authors.affiliation: Fausto Catena, Department of Emergency and Trauma Surgery, University Hospital of Parma, 43100 Parma, Italy.
authors.forename: Salomone
authors.initials: S
authors.lastname: Di Saverio
authors.affiliation: Fausto Catena, Department of Emergency and Trauma Surgery, University Hospital of Parma, 43100 Parma, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Coccolini
authors.affiliation: Fausto Catena, Department of Emergency and Trauma Surgery, University Hospital of Parma, 43100 Parma, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Ansaloni
authors.affiliation: Fausto Catena, Department of Emergency and Trauma Surgery, University Hospital of Parma, 43100 Parma, Italy.
authors.forename: Belinda
authors.initials: B
authors.lastname: De Simone
authors.affiliation: Fausto Catena, Department of Emergency and Trauma Surgery, University Hospital of Parma, 43100 Parma, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Sartelli
authors.affiliation: Fausto Catena, Department of Emergency and Trauma Surgery, University Hospital of Parma, 43100 Parma, Italy.
authors.forename: Harry
authors.initials: H
authors.lastname: Van Goor
keywords: Adhesive disease; Diagnosis of adhesive small bowel obstruction; Emergency surgical treatment; Intestinal obstruction; Non-operative management of adhesive disease