Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of General Surgery

Adhesive Small bowel obstruction (ASBO) is one of the most common surgery-related small intestine problems. Due to the lack of distinguishing laboratory findings and the inability of currently available imaging modalities to detect adhesions, many cases of ASBO will go misdiagnosed for lengthy periods of time, putting medical professionals in a diagnostic and therapeutic bind. The therapeutic role of water-soluble contrast has been studied in patients admitted with ASBO, in addition to its efficacy in predicting the need for operative treatment. The aim of our study is to assess the reliability of oral contrast media in predicting the success of conservative treatment in patients presenting with ASBO by following up the patient after the intake of contrast and monitoring vital signs and the improvement of symptoms indicating relief of obstruction.Patients and methods: The study included 68 patients presenting to the emergency department of Cairo University hospitals with adhesive small bowel obstruction in the period from the 1st of March to the last of October. Exclusion criteria included patients who are hamodynamically unstable or presenting with peritonitis with clinical evidence of intestinal strangulation. Pediatric and pregnant patients presenting with small bowel obstruction are not included. Results: Fifty one cases (75%) resolved completely without any operative intervention while only 17 patients required surgical intervention (25%). About 76% of patients with post contrast CT scan showing signs of small bowel obstruction after 2 and 24 hours of admission underwent surgery while the rest resolved after conservative management but required prolonged time of hospital stay

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