Bowel obstruction Non-operative management: Difference between revisions

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*Non-operative management indications include:<ref name="pmid20698371">{{cite journal |vauthors=Oyasiji T, Angelo S, Kyriakides TC, Helton SW |title=Small bowel obstruction: outcome and cost implications of admitting service |journal=Am Surg |volume=76 |issue=7 |pages=687–91 |year=2010 |pmid=20698371 |doi= |url=}}</ref><ref name="pmid3606237">{{cite journal |vauthors=Brolin RE, Krasna MJ, Mast BA |title=Use of tubes and radiographs in the management of small bowel obstruction |journal=Ann. Surg. |volume=206 |issue=2 |pages=126–33 |year=1987 |pmid=3606237 |pmc=1493109 |doi= |url=}}</ref><ref name="pmid18688562">{{cite journal |vauthors=Di Saverio S, Catena F, Ansaloni L, Gavioli M, Valentino M, Pinna AD |title=Water-soluble contrast medium (gastrografin) value in adhesive small intestine obstruction (ASIO): a prospective, randomized, controlled, clinical trial |journal=World J Surg |volume=32 |issue=10 |pages=2293–304 |year=2008 |pmid=18688562 |doi=10.1007/s00268-008-9694-6 |url=}}</ref><ref name="pmid27022449">{{cite journal |vauthors=Catena F, Di Saverio S, Coccolini F, Ansaloni L, De Simone B, Sartelli M, Van Goor H |title=Adhesive small bowel adhesions obstruction: Evolutions in diagnosis, management and prevention |journal=World J Gastrointest Surg |volume=8 |issue=3 |pages=222–31 |year=2016 |pmid=27022449 |pmc=4807323 |doi=10.4240/wjgs.v8.i3.222 |url=}}</ref><ref name="pmid26402543">{{cite journal |vauthors=Azagury D, Liu RC, Morgan A, Spain DA |title=Small bowel obstruction: A practical step-by-step evidence-based approach to evaluation, decision making, and management |journal=J Trauma Acute Care Surg |volume=79 |issue=4 |pages=661–8 |year=2015 |pmid=26402543 |doi=10.1097/TA.0000000000000824 |url=}}</ref>
*Non-operative management indications include:<ref name="pmid20698371">{{cite journal |vauthors=Oyasiji T, Angelo S, Kyriakides TC, Helton SW |title=Small bowel obstruction: outcome and cost implications of admitting service |journal=Am Surg |volume=76 |issue=7 |pages=687–91 |year=2010 |pmid=20698371 |doi= |url=}}</ref><ref name="pmid3606237">{{cite journal |vauthors=Brolin RE, Krasna MJ, Mast BA |title=Use of tubes and radiographs in the management of small bowel obstruction |journal=Ann. Surg. |volume=206 |issue=2 |pages=126–33 |year=1987 |pmid=3606237 |pmc=1493109 |doi= |url=}}</ref><ref name="pmid18688562">{{cite journal |vauthors=Di Saverio S, Catena F, Ansaloni L, Gavioli M, Valentino M, Pinna AD |title=Water-soluble contrast medium (gastrografin) value in adhesive small intestine obstruction (ASIO): a prospective, randomized, controlled, clinical trial |journal=World J Surg |volume=32 |issue=10 |pages=2293–304 |year=2008 |pmid=18688562 |doi=10.1007/s00268-008-9694-6 |url=}}</ref><ref name="pmid27022449">{{cite journal |vauthors=Catena F, Di Saverio S, Coccolini F, Ansaloni L, De Simone B, Sartelli M, Van Goor H |title=Adhesive small bowel adhesions obstruction: Evolutions in diagnosis, management and prevention |journal=World J Gastrointest Surg |volume=8 |issue=3 |pages=222–31 |year=2016 |pmid=27022449 |pmc=4807323 |doi=10.4240/wjgs.v8.i3.222 |url=}}</ref><ref name="pmid26402543">{{cite journal |vauthors=Azagury D, Liu RC, Morgan A, Spain DA |title=Small bowel obstruction: A practical step-by-step evidence-based approach to evaluation, decision making, and management |journal=J Trauma Acute Care Surg |volume=79 |issue=4 |pages=661–8 |year=2015 |pmid=26402543 |doi=10.1097/TA.0000000000000824 |url=}}</ref>
**Early postoperative bowel obstruction  
**Early postoperative bowel obstruction  
***Bowel obstructions that occur early on post-operatively are less likely to be strangulations
***Bowel obstructions that occur early on post-operatively are less likely to be [[Strangulation|strangulations]]
**[[Inflammatory bowel disease]]
**[[Inflammatory bowel disease]]
***Must not be [[fulminant]] or having a history of refractory [[strictures]]
***Must not be [[fulminant]] or having a history of refractory [[strictures]]
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*A failure is categorised as an [[obstruction]] that persists for more than 5 days.
*A failure is categorised as an [[obstruction]] that persists for more than 5 days.
*The decision to move forward with [[surgery]] is based upon individual clinical status.
*The decision to move forward with [[surgery]] is based upon individual clinical status.
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date]]
​​[[Category:Emergency medicine]]
​​
[[Category:Emergency medicine]]


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Latest revision as of 16:13, 27 February 2018

Bowel obstruction Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Overview

Many patients without indications for surgery may initially undergo non-operative management of bowel obstruction. Non-operative treatment includes gastrointestinal decompression and water-soluble contrast. Success rates vary by etiology of bowel obstruction. Bowel obstruction caused by adhesion has a high success rate of resolving non-surgical, where as complete obstruction have low success rates.

Indications

Non-operative management

Gastrointestinal decompression

Water-soluble contrast

Observation

  • Patients are observed for a period not exceeding 12 - 24 hours after non-operative management has taken place.
  • If no improvement is noted, then the patient is recommended to be explored surgically.

Failure of non-operative management

  • A failure is categorised as an obstruction that persists for more than 5 days.
  • The decision to move forward with surgery is based upon individual clinical status.

References

  1. Oyasiji T, Angelo S, Kyriakides TC, Helton SW (2010). "Small bowel obstruction: outcome and cost implications of admitting service". Am Surg. 76 (7): 687–91. PMID 20698371.
  2. Brolin RE, Krasna MJ, Mast BA (1987). "Use of tubes and radiographs in the management of small bowel obstruction". Ann. Surg. 206 (2): 126–33. PMC 1493109. PMID 3606237.
  3. Di Saverio S, Catena F, Ansaloni L, Gavioli M, Valentino M, Pinna AD (2008). "Water-soluble contrast medium (gastrografin) value in adhesive small intestine obstruction (ASIO): a prospective, randomized, controlled, clinical trial". World J Surg. 32 (10): 2293–304. doi:10.1007/s00268-008-9694-6. PMID 18688562.
  4. Catena F, Di Saverio S, Coccolini F, Ansaloni L, De Simone B, Sartelli M, Van Goor H (2016). "Adhesive small bowel adhesions obstruction: Evolutions in diagnosis, management and prevention". World J Gastrointest Surg. 8 (3): 222–31. doi:10.4240/wjgs.v8.i3.222. PMC 4807323. PMID 27022449.
  5. Azagury D, Liu RC, Morgan A, Spain DA (2015). "Small bowel obstruction: A practical step-by-step evidence-based approach to evaluation, decision making, and management". J Trauma Acute Care Surg. 79 (4): 661–8. doi:10.1097/TA.0000000000000824. PMID 26402543.

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