Treatment of Intestinal Adhesions with Obstruction in Adhesive Small Bowel Obstruction with Peritonitis
Clinical Scenario
This protocol addresses adhesive small bowel obstruction (ASBO) in patients who present with signs of peritonitis, strangulation, or bowel ischemia — a subset of ASBO where conservative management is contraindicated and urgent intervention is required.
When This Protocol Applies
Non-operative management should always be tried in patients with adhesive small bowel obstruction, unless there are signs of peritonitis, strangulation, or bowel ischemia. These findings represent absolute contraindications for conservative treatment and define the population for this protocol.
Approach (Partial Overview)
Management involves immediate surgical exploration with adhesiolysis; the route of surgical access depends on clinical and patient-specific factors. The full protocol details selection criteria, procedural considerations, and the complete decision algorithm…
References
DOI: 10.1186/s13017-018-0185-2
- Non-operative management should always be tried in patients with adhesive small bowel obstruction, unless there are signs of peritonitis, strangulation, or bowel ischemia.
- Contraindications for non-operative treatment include peritonitis, strangulation, and ischemia.
- When operative treatment is required, a laparoscopic approach may be beneficial for selected cases of simple ASBO.
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