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TITLE:

BOWEL OBSTRUCTION-INDICATION AND ADVANCES IN SURGICAL MANAGEMENT

AUTHORS:

Doaa Hussain Alzaher, Zahra Ali M Al Saif, Zakeyah Adel Almubarak

ABSTRACT:

Introduction: Small bowel obstruction (SOB) constitutes approximately 15% of the acute surgical gastrointestinal admissions as well as approximately 15% of emergency admissions for abdominal pain. The majority of SBO patients are managed with nasogastric tube decompression. But, the mortality of SBO is still high and significant ranging from 2% to 8% per year and might increase to as high as 25%. Management of SBO properly is critical to avoid unneeded surgical procedures for SBO that can be treated medically to improve patient morbidity and to prevent delays in cases in which surgery is necessary to decrease mortality. Aim of work: This article reviews the clinical presentation, pathophysiology, diagnosis, management, and recent advancement in surgical procedure. Methodology: We did a systematic search for bowel obstruction and advanced surgical management using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). Conclusions: The majority of SBO patients are managed with nasogastric tube decompression. Management of SBO properly is critical to avoid unneeded surgical procedures for SBO that can be treated medically to improve patient morbidity and to prevent delays in cases in which surgery is necessary to decrease mortality. Presentations of SBO include the followings: history of previous abdominal or pelvic surgery, radiation, history of cancer or mass; especially cancers of the ovaries and colon. Plain Radiography is usually the first step done, it is cheap and widely available in many settings. CT scanning is the study of choice. Initially in the emergency department, the management of SBO consists of aggressive fluid resuscitation and bowel decompression. If there are signs of strangulations, the case is considered for surgical emergency. A surgical option for SBO is indicated for several etiologies and conditions. SBO can be effectively managed with the laparoscopic approach. Keywords: small bowel obstruction, acute abdomen, abdominal pain, abdominal surgery

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