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Obstrução do intestino delgado

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 13 Sep 2025
Last updated: 15 Aug 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • dor abdominal
  • constipação/falha na passagem de gases ou fezes
  • vômitos
  • distensão abdominal
  • desconforto abdominal
  • peritonite
  • massa abdominal palpável
Full details

Other diagnostic factors

  • náuseas
  • febre
  • taquicardia
  • taquipneia
  • letargia intensa
  • hipotensão
  • diarreia
  • edema na virilha
Full details

Risk factors

  • cirurgia abdominal prévia
  • neoplasia maligna intestinal
  • má rotação
  • Doença de Crohn
  • hérnia
  • intussuscepção
  • volvo
  • atresia intestinal
  • apendicite
  • ingestão de corpo estranho
Full details

Diagnostic investigations

1st investigations to order

  • tomografia computadorizada (TC) abdominal
  • Hemograma completo
  • ureia
  • painel de eletrólitos
Full details

Investigations to consider

  • radiografias abdominais
  • estudo com contraste hidrossolúvel
  • laparotomia/laparoscopia
  • ultrassonografia abdominal
  • ressonância nuclear magnética (RNM) abdominal
Full details

Treatment algorithm

ACUTE

OID complicada ou estrangulada: candidatos a cirurgia

OID complicada ou estrangulada: cirurgia não indicada

OID simples

Contributors

Authors

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

Disclosures

AM declares that he has no competing interests.

Acknowledgements

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.

Disclosures

JTJ , ETP, GM, FJM, and DJH declare that they have no competing interests.

Peer reviewers

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.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

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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