OUTCOME OF CONSERVATIVE MANAGEMENT OF ADHESIVE SMALL BOWEL OBSTRUCTION

Background: Adhesive intestinal obstruction is a common surgical emergency. Controversies exist in its management. This study was designed to assess the outcome of conservative treatment of adhesive small bowel obstruction. Methods: This descriptive study was carried out at Saidu Teaching Hospital Swat from July 2007 to June 2010. Patients who presented to Department of Surgery with adhesive small bowl obstruction were included in the study. Initially all patients were managed by intravenous hydration and nasogastric tube decompression. Surgical intervention was determined on the presence of one or more toxic signs e.g. fever, leukocytosis, intractable pain, and peritonitis or if obstruction did not resolve spontaneously in four days. Patients were followed-up for six months. Results: Seventy-three adult patients with adhesive small bowel obstruction were studied. Male to female ratio was 1: 1 and age range 16-68 years. Out of these 52(71.23%) patients responded to conservative treatment and 21(28.76%) required surgical intervention. Of these 21 patients, 14(66.66%) needed adhesion lysis only while 6(28.5%) required gut resection. Median hospital stay for conservative group was 3.69 days (range 3-8 days) while in operative group 8.76 days (range 7-15 days). Conclusion: Most patients with adhesive small bowel obstruction will benefit from conservative treatment as the resolution rate is high (71%).