Small Bowel Obstruction

Excerpt

Small bowel obstruction (SBO) is a common and potentially life-threatening surgical emergency that accounts for a significant proportion of hospital admissions. This condition is characterized by the triad of abdominal pain, vomiting, and abdominal distension, reflecting the disruption of normal intestinal flow. SBO can be broadly categorized into simple obstructions, which involve mechanical blockage without ischemia, and strangulated obstructions, which are associated with compromised blood flow, bowel ischemia, and potential necrosis. Prompt diagnosis and management are critical to prevent severe complications, including gangrenous bowel and perforation.

The most common cause of SBO is postoperative adhesions, followed by hernias, while other etiologies include malignancies, inflammatory strictures, and congenital anomalies. Initial management includes fluid and electrolyte resuscitation, nasogastric tube decompression, and early identification of strangulation. Imaging, particularly computed tomography (CT), is pivotal in confirming the diagnosis and guiding treatment. Nonoperative management is often effective for partial obstructions, while surgical intervention, such as adhesiolysis or bowel resection, is required in cases of complete obstruction, ischemia, or perforation. This activity examines the pathophysiology, clinical presentation, diagnostic workup, and management strategies for SBO, emphasizing evidence-based practices and recent advances in care.