Download PDF
Clin Colon Rectal Surg 2006; 19(4): 181-187
DOI: 10.1055/s-2006-956438
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Reoperation for Small Bowel Obstruction-How Critical Is the Timing?

Joseph C. Carmichael1 , Steven Mills1
  • 1Division of Colon and Rectal Surgery, Department of Surgery, University of California, Irvine Medical Center, Orange, California
Further Information

Publication History

Publication Date:
24 November 2006 (online)

Also available at
   Buy Article Permissions and Reprints
Zoom Image

ABSTRACT

The timing of reoperation for small bowel obstruction is a topic of significant debate. Any patient with evidence of strangulation should undergo urgent surgical intervention. However, predicting strangulation can be difficult. Because of this, previous authors have recommended everything from emergency operation for all patients presenting with small bowel obstruction to periods of observation that extend up to 14 days. Over the past century, the primary etiology of small bowel obstruction has shifted from hernias to postoperative adhesive disease, leading to a shift in the management paradigm. To manage small bowel obstruction successfully today, the clinician must distinguish the patient requiring urgent operation from those who benefit from nonoperative management. Furthermore, the clinician must be able to determine the appropriate length of time for conservative management. In this article we review the significant body of literature on this topic including the diagnostic workup and timing of potential operative intervention in the patient with small bowel obstruction.

KEYWORDS

Bowel - obstruction - reoperation - reoperative - timing