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Highlights & Basics
- Small bowel obstruction (SBO) is a medical emergency that requires early diagnosis and potential surgical intervention.
- It typically presents with the combined symptoms of abdominal pain, bloating, vomiting, and failure to pass flatus or stool per rectum. Peritonitis is generally present if the obstruction has progressed to ischemia/gangrene and/or perforation.
- Diagnosis is generally based upon clinical and imaging features. A computed tomography (CT) scan of the abdomen is usually the initial imaging modality.
- Treatment involves a combination of nasogastric decompression and intravenous fluids. Surgery may be required, so the diagnosis requires urgent surgical assessment.
- Patients who are treated in a timely manner have a very good prognosis. If untreated, it can progress to intestinal necrosis, perforation, sepsis, and multi-organ failure.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Abdominal CT scan showing small bowel obstruction with multiple air-fluid levels, dilated bowel loops and a transition zone in the right iliac fossa. Red arrows indicate the evident transition zone
Abdominal x-ray showing partial intestinal obstruction
Abdominal x-ray showing complete intestinal obstruction
Citations
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American College of Radiology. ACR appropriateness criteria: suspected small-bowel obstruction. 2019 [internet publication].[Full Text]
Ten Broek RPG, Krielen P, Di Saverio S, et al. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the World Society of Emergency Surgery ASBO Working Group. World J Emerg Surg. 2018 Jun 19;13:24.[Abstract][Full Text]
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