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Year : 2021  |  Volume : 14  |  Issue : 3  |  Page : 112-114

Incidence of adhesive small bowel obstruction and outcome of management

Department of General Surgery, Rashid Hospital, Dubai, United Arab Emirates

Correspondence Address:
Maahroo Makhdoom
Department of General Surgery, Rashid Hospital, Oud Mehta Road, PO Box: 4545, Dubai
United Arab Emirates
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/hmj.hmj_69_20

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Background: Small bowel obstruction (SBO) is a common surgical condition that leads to emergency admission. Adhesions are the single most common cause for SBO, accounting for 60% of cases. The occurrence of adhesive SBO (ASBO) is higher following specific surgeries including colorectal, high gynaecological and paediatric surgeries. Initially, all patients are treated conservatively, but in case they fail to improve, surgical management is considered. Aim & Objectives: The objective of the study is to assess the number of patients admitted at Rashid Hospital with ASBO and the outcomes of their management. Materials and Methods: A retrospective study was conducted on patients who were admitted with ASBO from April 2017 until December 2019. A total of number of 85 patients who met the inclusion criteria were enrolled in the study. Those with underlying inflammatory bowel disease, abdominal tuberculosis and small bowel tumours were excluded. The outcomes of non-operative management (NOM) in terms of success rate, length of hospital stay and surgical intervention were assessed. Result: A total of 303 records were reviewed, of which 85 met the inclusion criteria (50 males and 35 females). The most common type of previous abdominal surgeries includes lower gastrointestinal (38.8%) and gynaecological surgeries (12.9%). Seventy-eight patients who underwent NOM had a success rate of 77.6% (n = 59) with a mean length of stay (LOS) of 3.5 days. Seventeen patients (22.4%) needed surgical intervention after a mean of 3.5 days. These patients were found to have intra-abdominal bands in 52.9% of the cases (P = 0.191). During the time period set for the study, the recurrence rate of patients who had successful NOM versus those who needed surgical intervention was 12% and 35.3%, respectively (P = 0.061). Sixty per cent of these recurrent cases were treated non-operatively on the second admission to the hospital whereas 40% required surgical intervention. Conclusion: NOM for ASBO has a shorter LOS and a lower recurrence rate as compared to those who required surgical management.

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