Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- abdominal pain
- constipation/failure to pass flatus or stool
- vomiting
- abdominal distention
- abdominal tenderness
- peritonitis
- presence of risk factors
- palpable abdominal mass
Outros fatores diagnósticos
- nausea
- fever
- tachycardia
- tachypnea
- severe lethargy
- hypotension
- diarrhea
- groin swelling
Fatores de risco
- previous abdominal surgery
- intestinal malignancy
- malrotation
- Crohn disease
- hernia
- intussusception
- volvulus
- intestinal atresia
- appendicitis
- foreign body ingestion
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- abdominal CT scan
- CBC
- BUN
- electrolyte panel
Investigações a serem consideradas
- abdominal x-rays
- water-soluble contrast study
- laparotomy/laparoscopy
- abdominal ultrasound
- abdominal MRI
Algoritmo de tratamento
complicated or strangulated SBO: surgical candidate
complicated or strangulated SBO: surgery not indicated
simple SBO
Colaboradores
Consultores especialistas
Adrian Maung, MD, MBA, FACS, FCCM
Associate Professor of Surgery
Division of General Surgery, Trauma and Surgical Critical Care
Department of Surgery
Yale School of Medicine
New Haven
CT
Declarações
AM declares that he has no competing interests.
Agradecimentos
Dr Adrian Maung would like to gratefully acknowledge Dr John T. Jenkins, Dr Edward T. Pring, Dr George Malietzis, Dr Frances J. McNicol, and Dr David J. Hackam, previous contributors to this topic.
Declarações
JTJ , ETP, GM, FJM, and DJH declare that they have no competing interests.
Revisores
Steven D. Wexner, MD, FACS, FRCS, FRCS (Ed)
Chief Academic Officer
Emeritus Chief of Staff (1997-2007)
Chairman Department of Colorectal Surgery
Professor of Surgery Ohio State University
Affiliate Professor Department of Surgery
Division of General Surgery
University of South Florida College of Medicine
Cleveland Clinic Florida
FL
Declarações
SDW declares that he has no competing interests.
Referências
Principais artigos
Maung AA, Johnson DC, Piper GL, et al; Eastern Association for the Surgery of Trauma. Evaluation and management of small-bowel obstruction: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012 Nov;73(5 suppl 4):S362-9.Texto completo Resumo
Jackson P, Vigiola Cruz M. Intestinal obstruction: evaluation and management. Am Fam Physician. 2018 Sep 15;98(6):362-7. Resumo
American College of Radiology. ACR appropriateness criteria: suspected small-bowel obstruction. 2019 [internet publication].Texto completo
Ten Broek RPG, Krielen P, Di Saverio S, et al. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the World Society of Emergency Surgery ASBO Working Group. World J Emerg Surg. 2018 Jun 19;13:24.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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