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Revista colombiana de Gastroenterología
versión impresa ISSN 0120-9957versión On-line ISSN 2500-7440
Resumen
IDROBO, Anuar Armando et al. Presentation and outcome of conservative management of intestinal obstruction caused by adhesions in Cauca. Rev. colomb. Gastroenterol. [online]. 2020, vol.35, n.4, pp.447-454. Epub 12-Jul-2021. ISSN 0120-9957. https://doi.org/10.22516/25007440.517.
Introduction:
Intestinal obstruction by adhesions accounts for 25% of consultations to the emergency department associated with acute abdominal pain, generating a high risk of iatrogenic injury by emergency reinterventions. An alternative to determine the need for surgical treatment is providing conservative medical management first and then assessing patients’ response within 12-72 hours.
Objective:
To describe the clinical outcomes of adult patients with bowel obstruction caused by adhesions treated at a tertiary care hospital who received non-surgical medical treatment on admission.
Methodology:
Observational, prospective cohort study on patients treated conservatively during the period 2012-2013 for intestinal obstruction. Socio-demographic and clinical information was collected from patients, and follow-up was done until discharge. The analysis was carried out using descriptive statistics in SPSS v15.
Results:
58.9% of the cases occurred in men, and the average age was 55.2 years. 57.1% of the patients had comorbidities predominantly associated with cardiovascular diseases, and 91.1% had previously undergone a surgical procedure, half of them due to inflammatory processes. The most common symptoms were emesis and abdominal distention. The response to conservative treatment was 80.4% of the 19.6% that required surgical management. In 81.8% of the cases, intestinal obstruction caused by adhesions was the main intraoperative finding. The average time of hospitalization was 5.5 days, and during the study only one patient died.
Conclusion:
Conservative medical management should be considered as the initial treatment for this entity due to its high response rate, reduction of postoperative complications, and shorter hospital stay.
Palabras clave : Intestinal obstruction; Peritoneum; Gastrointestinal motility; Signs and symptoms.