PREDICTORS OF SURGICAL INTERVENTION IN ADHESIVE SMALL BOWEL OBSTRUCTION: A TERTIARY-CARE RETROSPECTIVE STUDY

Abstract

Background: Adhesive small bowel obstruction (SBO) is a common acute surgical presentation. A shift toward non operative management has made early identification of patients who will fail conservative therapy an important clinical goal. Methods: In this retrospective analytical study, 50 consecutive patients with adhesive SBO (November 2023–January 2024) were divided into an operative group (Group A, including patients who failed initial non-operative management) and a non-operative group (Group B). Clinical, biochemical, and imaging data were collected; imaging was reviewed by a radiologist blinded to outcomes. Results: Clinical symptoms (nausea, vomiting, obstipation) did not clearly distinguish the groups, whereas abdominal pain and distension differed. Cross-sectional imaging findings — a definite transition point, free intraperitoneal fluid, and absence of the small-bowel faeces sign — were reported as predictive of the need for surgery. Conclusion: CT findings, rather than clinical symptoms, best predict failure of non-operative management in adhesive SBO and should prompt early surgical planning; the statistical analysis requires correction before definitive inference.