Evaluation of Small Bowel Obstruction of the Virgin Abdomen in the CT Era

Hafiz, S; Yi, W.S.; O'Leary, Elizabeth Ann; Garg, Gaurav; Sava, Jack

doi:10.1016/j.jss.2012.10.868

Cited by 1 publication

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“…After deduplication, 913 unique citations were screened using titles and abstracts. We identified 46 citations which warranted a full-text reviews, however, attempts to contact the authors of 3 abstracts, with the goal of obtaining the full texts were unsuccessful, so these citations were excluded [31][32][33] After reviewing the full text of 43 studies, 6 were found to have met all inclusion criteria-2 retrospective cohort studies [10,34] and 4 case series (initial reviewer agreement, j = 0.71) [16,17,35,36] No additional studies were identified by hand searching the references of studies selected for full review (Fig. 1).…”

Section: Identified Studiesmentioning

confidence: 99%

Non‐operative Management of Small Bowel Obstruction in Patients with No Previous Abdominal Surgery: A Systematic Review and Meta‐analysis

et al. 2021

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While the contemporary management of adhesive small bowel obstruction (SBO) often includes a trial of non-operative management (NOM), surgical dogma dictates urgent operative exploration in patients without previous abdominal surgery. This dogma has been challenged by recent evidence suggesting most obstructions in this population are adhesive in nature. The objectives of this review were to evaluate the feasibility of NOM in patients with SBO and no history of previous abdominal surgery, to examine the etiologies of SBO in this population, and to explore the rate of adverse events seen following NOM. Embase, Medline, Cochrane, and Google Scholar were searched from inception to September 24, 2019. Articles reporting on NOM for SBO in patients without previous abdominal surgery and without clinical or radiographic features necessitating an emergent operation were included. Data were combined to obtain a pooled proportion of patients discharged without operation following a trial of NOM. 6 studies reporting on a total of 272 patients were included. The pooled proportion of patients discharged following NOM was 49.5% (95% CI 23.7-75.3%). Adhesions were found to be the predominant cause of obstruction. NOM did not appear to increase short-term complications. Most SBOs in patients without previous abdominal surgery are adhesive in nature and many patients can be discharged from hospital without surgery. While the short-term outcomes of NOM are acceptable, future studies are needed to address the long-term outcomes and safety of NOM as a treatment strategy for SBO in patients without previous abdominal surgery.

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