THE ROLE OF CONSERVATION AND FACTORS PREDICTING SURGICAL TREATMENT IN ADHESIVE BOWEL OBSTRUCTION
Sah Prasad Rupesh*, Awale Laligen, Pandit Narendra, Khaniya Sudeep and Adhikary Shailesh
ABSTRACT
Background: Post-operative adhesions are a frequently encountered problem after abdominal surgeries. Surgerypostoperative
adhesions- Surgery is a continuous process and we have to break this process. There is always a
debate about the optimal treatment: surgical or medical management. This study is done to evaluate how long
patients with bowel obstruction caused by postoperative adhesions can tolerate conservative treatment and also to
determine the predictive factors which indicate operation. Methods: Thirty patients with previous laparotomy
diagnosed as intestinal obstruction were prospectively analysed and were enrolled in this study. Results: During
the one year period, thirty patients were included in the study who met the inclusion criteria; 18 (60%) patients
were treated conservatively and 12 (40%) patients underwent surgical intervention. In a total of 30 patients, 10
(33.3%) patients attended follow up clinic and were fine with no complaints. Eight (66.7%) in operated group
attended follow up clinic and were fine. Conclusion: The actual incidence of serious complications in patients
with small bowel obstruction due to postoperative adhesions is low. The effectiveness of the most common
treatment option was related to clinical, laboratory and radiological parameters. Most patients could be managed
conservatively. Close monitoring in the absence of clinical signs suggestive of complications. There is no
limitation of an observation period before proceeding to surgical intervention is required.
Keywords: Adhesive bowel obstruction, conservative management, surgery.
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