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Many patients with adhesive small bowel obstruction (SBO) can be managed nonsurgically. In this retrospective study from a French hospital, researchers sought to determine whether findings on computed tomography (CT) can predict response to nonsurgical treatment. They identified 159 patients with presumed adhesive SBO who underwent CT and were treated nonsurgically (initially); patients were included if CT showed proximal dilated small bowel (≥2.5 cm), normal or collapsed distal small bowel, and absence of mass, hernia, or inflammatory stenosis. Patients who underwent immediate surgery because of suspected ischemia were excluded.
Nonsurgical treatment was successful in 71% of patients; 29% underwent surgery within 14 days. Of the 11 potentia…