Regarding adhesive intestinal obstruction, TRUE is –
Correct Answer: Avoid surgery for initial 48-72 hours
Description: There are three main measures in the t/t of acute intestinal obstruction. These are
Gastro intestinal drainage (Nasogastric suction)
Fluid and electrolyte replacement
Surgery for relief of obstruction
The first two steps are always necessary prior to the surgical relief of obstruction.
Surgical treatment is necessary for most cases of intestinal obstruction, but it should always be delayed until resuscitation is complete.
The timing of surgical intervention is dependent on clinical picture.
The classical clinical advice on a case of unrelieved intestinal obstruction is that "Sun should not both rise and set" i.e., the operative procedure should not be delayed beyond 24 hrs.
But, there are certain exceptions to this rule. In some cases operation is delayed in the hope of spontaneous resolution.
In adhesive intestinal obstruction, usually occurring after surgery the conservative management is continued upto 72 hours in the hope of spontaneous resolution. In these cases there is no pain or tenderness despite continued radiological evidence of obstruction.
Also know the four types of obstruction, where operation should be done as soon as possible these are
Strangulation
Closed loop obstruction
Colon obstruction
Early simple mechanical obstruction
Category:
Surgery
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