Management of Small Bowel Obstruction

Management of Small Bowel Obstruction

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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.