Small Bowel Obstruction
Blockage preventing food from passing through the small intestine, often requiring surgery.
Overview
Small bowel obstruction (SBO) is one of the most common surgical emergencies worldwide. Adhesions from previous surgery cause 60-75% of cases. Timely intervention is critical — delayed treatment of strangulated bowel leads to gangrene, perforation, and sepsis.
Causes
- Post-surgical adhesions (60-75%)
- Hernias (incarcerated inguinal/incisional)
- Tumors (small bowel or metastatic)
- Crohn's disease strictures
- Volvulus
- Intussusception
- Gallstone ileus
- Foreign body
Risk Factors
- Previous abdominal surgery (strongest risk)
- Hernia
- Intra-abdominal malignancy
- Crohn's disease
- Radiation enteritis
- Previous peritonitis
Symptoms
Diagnosis
- Abdominal X-ray (multiple air-fluid levels, dilated loops)
- CT abdomen with contrast (gold standard — identifies cause, site, and complications)
- Blood tests (lactate elevation = strangulation)
- Clinical assessment for peritonitis signs
Treatment Options
Surgical Treatment
Conservative management (NGT decompression, IV fluids, nil by mouth) succeeds in 60-70% of adhesive SBO within 48-72 hours. Surgery is indicated for: failed conservative management, signs of strangulation (peritonitis, fever, tachycardia, rising lactate), complete obstruction, or closed-loop obstruction. Dr. Bhagat performs laparoscopic adhesiolysis when feasible.
Recovery
Conservative: Resolution in 2-5 days, gradual diet resumption. Surgical: 4-7 days hospital stay, start oral diet when bowel function returns (flatus/stool). Adhesion barrier products may reduce future adhesions.
Prevention
- Laparoscopic surgery (fewer adhesions than open)
- Adhesion barriers during surgery
- Early mobilization after surgery
- Hernia repair before incarceration
- Prompt treatment of Crohn's strictures
Frequently Asked Questions
How do I know if bowel obstruction is an emergency?
Can bowel obstruction recur?
Expert Consultation Available
Get personalized treatment advice from Dr. Bhagat. Book an appointment or connect via WhatsApp for a quick consultation.