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Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 World+J+Gastrointest+Surg 2016 ; 8 (3): 222-31 Nephropedia Template TP
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Adhesive small bowel adhesions obstruction: Evolutions in diagnosis, management and prevention #MMPMID27022449
Catena F; Di Saverio S; Coccolini F; Ansaloni L; De Simone B; Sartelli M; Van Goor H
World J Gastrointest Surg 2016[Mar]; 8 (3): 222-31 PMID27022449show ga
Intra-abdominal adhesions following abdominal surgery represent a major unsolved problem. They are the first cause of small bowel obstruction. Diagnosis is based on clinical evaluation, water-soluble contrast follow-through and computed tomography scan. For patients presenting no signs of strangulation, peritonitis or severe intestinal impairment there is good evidence to support non-operative management. Open surgery is the preferred method for the surgical treatment of adhesive small bowel obstruction, in case of suspected strangulation or after failed conservative management, but laparoscopy is gaining widespread acceptance especially in selected group of patients. "Good" surgical technique and anti-adhesive barriers are the main current concepts of adhesion prevention. We discuss current knowledge in modern diagnosis and evolving strategies for management and prevention that are leading to stratified care for patients.