2011年8月4日 星期四

Management of Small Bowel Obstruction

Guidelines for Management of Small Bowel Obstruction
J Trauma. 2008;64:1651–1664.
Diagnosis

Management
  • 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
  1. mild abdominal distention allowing adequate visualization
  2. a proximal obstruction
  3. a partial obstruction
  4. an anticipated single-band obstruction
  • Patients who have advanced, complete, or distal SBOs are not candidates for laparoscopic treatment.

沒有留言: