POSTLAPAROSCOPIC SMALL-BOWEL OBSTRUCTION - RETHINKING ITS MANAGEMENT

Background: Patients with early postoperative small bowel obstruction (SBO) are usually managed nonoperatively with nasogastric suction, int ravenous fluids, and observation. The majority of early postoperative SBO resolve without an operation. Methods: We performed a retrospectiv e review of patients who had been diagnosed with postlaparoscopic SBO at three Chicago area teaching hospitals. Results: The patients were i nitially managed nonoperatively for up to 7 days. However, all of them subsequently required an operation. In every case, the postlaparoscop ic SBO was caused by the small bowel being incarcerated in a peritonea l defect created either by trocar placement or peritoneal incision for herniorrhaphy. Conclusion: In contradistinction to the approach used for early SBO after laparotomy, prompt operative intervention for post laparoscopic SBO is recommended.