Adhesive small bowel obstruction: How long can patients tolerate conservative treatment?

AIM TO evaluate how long patients with small bowelobstruction caused by postoperative adhesions can tolerateconservative treatment.METHODS:The records of patients with small bowelobstruction due to postoperative adhesions wereretrospectively reviewed.Data collected included the numberof admissions,type of management for each admission,duration of conservative treatment,number of repeatlaparotomies,and operative findings.RESULTS:One hundred fifty-five patients with this conditionfrom January 1999 to December 2001,for a total of 293admissions were enrolled in this study.Medical treatmentalone was given in 220 admissions,and repeat laparotomywas performed in 73 admissions.The period of observationin patients managed medically ranged from 2 to 12 days(average:6.9 days),while for those who underwent surgery,the range was 1 to 14 days(average 5.4 days).At surgery,adhesions were the only finding in 46 cases,while therewere intestinal complications in 27,or 9.2 % of all 293admissions.Fever and leukocytosis greater than 15 000/mm~3were prediction of intestinal complications.CONCLUSION:With closely monitoring,most patients withsmall bowel obstruction due to postoperative adhesions couldtolerate supportive treatment and recover well averagelywithin 1 week,although some patients require more than10 days of observation.