Small-Bowel Obstruction Questions & Answers

Updated: Apr 28, 2017
  • Author: Mityanand Ramnarine, MD, FACEP; Chief Editor: Steven C Dronen, MD, FAAEM  more...
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Questions & Answers

Overview

What causes small-bowel obstruction (SBO), and how common is it?

How are the symptoms of small-bowel obstruction (SBO) characterized?

What are the signs and symptoms commonly associated with small-bowel obstruction (SBO)?

What are the risk factors associated with small-bowel obstruction (SBO)?

Which adjunctive lab tests are used in the evaluation of small-bowel obstruction (SBO)?

Which lab tests are used to exclude biliary or hepatic disease in small-bowel obstruction (SBO)?

Which imaging study is used in the initial workup of small-bowel obstruction (SBO)?

What is the role of multislice CT scanning in the evaluation of small-bowel obstruction (SBO)?

What is the role of ultrasonography in the evaluation of small-bowel obstruction (SBO)?

What is the role of enteroclysis in the evaluation of small-bowel obstruction (SBO)?

What are the nonoperative treatments for small-bowel obstruction (SBO) and how does treatment vary based on the cause of the SBO?

When is surgical intervention indicated in the treatment of small-bowel obstruction (SBO)?

What is the incidence of small-bowel obstruction (SBO) and what are the causes of SBO?

Which abdominal surgeries are most commonly associated with small-bowel obstruction (SBO)?

What are the classifications of small-bowel obstruction (SBO)?

What is the pathophysiology of small-bowel obstruction (SBO)?

Which cause of small-bowel obstruction (SBO) is most commonly associated with strangulation?

How does bacteremia due to E coli occur in small-bowel obstruction (SBO)?

What is the most common cause of small-bowel obstruction (SBO)?

How can small-bowel obstruction (SBO) be prevented?

What are the most common causes of small-bowel obstruction (SBO) in developed countries, in children, and in developing countries?

What is the prognosis of small-bowel obstruction (SBO)?

What is the mortality rate of strangulated small-bowel obstruction (SBO)?

Which factors are associated with death and postoperative complications in small-bowel obstruction (SBO)?

What are the potential complications and associated contributing factors of small-bowel obstruction (SBO)?

Which cardiac and pulmonary complications are associated with small-bowel obstruction (SBO)?

Presentation

How are small-bowel obstructions (SBOs) characterized and what are the known complications?

How do patients describe the abdominal pain associated with small-bowel obstruction (SBO) and what are common presentations of SBO?

What are common complaints of patients with small-bowel obstruction (SBO)?

How common is abdominal distention in patients with small-bowel obstruction (SBO) and what do abnormal bowel sounds indicate?

What are the essential elements of a physical exam for small-bowel obstruction (SBO) used to identify possible causes as well as exclude causes from the differential diagnosis?

What are the signs of intestinal ischemia that should be checked in the physical exam for small-bowel obstruction (SBO)?

How is a simple small-bowel obstruction (SBO) differentiated from an early strangulated obstruction?

DDX

Which conditions should be considered in the differential diagnosis of small-bowel obstruction (SBO)?

What are the differential diagnoses for Small-Bowel Obstruction?

Workup

Which lab tests are indicated if the diagnosis of small-bowel obstruction (SBO) is unclear?

Which lab studies are used to exclude biliary or hepatic disease in the workup of small-bowel obstruction (SBO)?

When are plain radiographs obtained in the workup of small-bowel obstruction (SBO) and how definitive are they?

How does the sensitivity and specificity of plain radiography compare to that of CT scanning in the evaluation of small-bowel obstruction (SBO)?

What is the role of the radiologist’s experience in the evaluation of small-bowel obstruction (SBO) and which radiographic signs are most significant?

What are the limitations of X-ray imaging in the workup of small-bowel obstruction (SBO)?

What is the role of radiography in distinguishing the different types of small-bowel obstructions (SBO)?

Which radiographic findings indicate small-bowel obstruction (SBO)?

What is the role of enteroclysis in the workup of small-bowel obstruction (SBO)?

What is the role of CT enterography/CT enteroclysis in the workup of small-bowel obstruction (SBO)?

When is CT scanning the study of choice in small-bowel obstruction (SBO)?

What are the advantages of CT scanning in the workup of small-bowel obstruction (SBO)?

How is a small-bowel obstruction (SBO) demonstrated on CT scanning?

How accurate is CT scanning in the detection of a small-bowel obstruction (SBO)?

How accurate is MRI in the detection of a small-bowel obstruction (SBO)?

What are the advantages of MRI in the workup of small-bowel obstruction (SBO) in pregnancy?

What are the advantages of ultrasonography in the workup of small-bowel obstruction (SBO)?

How does ultrasonography compare to radiography for the detection of small-bowel obstruction (SBO) by emergency physicians?

Treatment

What are the World Society of Emergency Surgery guidelines for the diagnosis and management of adhesive small-bowel obstruction (ASBO)?

What is the initial emergency department (ED) treatment of small-bowel obstruction (SBO)?

Which vital signs should be monitored during emergency department (ED) care for small-bowel obstruction (SBO)?

What is the role of nasogastric (NG) suction in the treatment of small-bowel obstruction (SBO)?

What is the role of nonoperative treatment in the management of small-bowel obstruction (SBO)?

What is the role of water-soluble oral contrast medium (WSCM) in the treatment of small-bowel obstruction (SBO)?

When is surgical care indicated in the treatment of small-bowel obstruction (SBO)?

What is the role of laparoscopy in the treatment of small-bowel obstruction (SBO)?

What are the morbidity and mortality risks associated with surgical treatment of small-bowel obstruction (SBO)?

Medications

Which medications are used in the initial treatment of small-bowel obstruction (SBO)?

Which medications in the drug class Antibiotics are used in the treatment of Small-Bowel Obstruction?

Which medications in the drug class Antiemetic are used in the treatment of Small-Bowel Obstruction?

Which medications in the drug class Analgesics are used in the treatment of Small-Bowel Obstruction?