J Trauma. 2008;64:1651–1664.Diagnosis
- Patients with plain film finding of SBO and clinical markers (fever, leukocytosis, tachycardia, metabolic acidosis, and continuous pain) or peritonitis on physical examination warrant exploration.
- Patients without the above mentioned clinical picture with a partial SBO or a complete SBO can undergo nonoperative management safely.
- Patients without resolution of their SBO by day 3 to 5 of non-operative management should undergo water soluble study or surgery.
- Criteria for consideration of laparoscopic management
- mild abdominal distention allowing adequate visualization
- a proximal obstruction
- a partial obstruction
- an anticipated single-band obstruction
- Patients who have advanced, complete, or distal SBOs are not candidates for laparoscopic treatment.