Catena F, Di Saverio S, Coccolini F, Ansaloni L, De Simone B, Sartelli M, Van Goor H. Adhesive small bowel adhesions obstruction: Evolutions in diagnosis, management and prevention. World J Gastrointest Surg 2016; 8(3): 222-231 [PMID: 27022449 DOI: 10.4240/wjgs.v8.i3.222]
Corresponding Author of This Article
Fausto Catena, MD, PhD, FRCS, Department of Emergency and Trauma Surgery, University Hospital of Parma, Via Gramsci 11, 43100 Parma, Italy. faustocatena@gmail.com
Research Domain of This Article
Emergency Medicine
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Mar 27, 2016; 8(3): 222-231 Published online Mar 27, 2016. doi: 10.4240/wjgs.v8.i3.222
Adhesive small bowel adhesions obstruction: Evolutions in diagnosis, management and prevention
Fausto Catena, Salomone Di Saverio, Federico Coccolini, Luca Ansaloni, Belinda De Simone, Massimo Sartelli, Harry Van Goor
Fausto Catena, Department of Emergency and Trauma Surgery, University Hospital of Parma, 43100 Parma, Italy
Salomone Di Saverio, Department of Surgery, Maggiore Hospital of Bologna, 42121 Bologna, Italy
Federico Coccolini, Luca Ansaloni, Department of General and Emergency Surgery, Papa Giovanni XIII Hospital, 24121 Bergamo, Italy
Belinda De Simone, Department of Emergency and Trauma Surgery, University Hospital of Parma, 43100 Parma, Italy
Massimo Sartelli, Department of Surgery, Macerata Hospital, 62100 Macerata, Italy
Harry Van Goor, Department of Surgery, Radboud University Medical Centre, 6500 Nijmegen, The Netherlands
Author contributions: Catena F and Van Goor H collected data and wrote the manuscript; all the authors read and approved the final manuscript.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Fausto Catena, MD, PhD, FRCS, Department of Emergency and Trauma Surgery, University Hospital of Parma, Via Gramsci 11, 43100 Parma, Italy. faustocatena@gmail.com
Telephone: +39-52-1703940 Fax: +39-52-1702163
Received: July 6, 2015 Peer-review started: July 8, 2015 First decision: September 8, 2015 Revised: December 26, 2015 Accepted: January 5, 2016 Article in press: January 7, 2016 Published online: March 27, 2016 Processing time: 258 Days and 19.3 Hours
Abstract
Intra-abdominal adhesions following abdominal surgery represent a major unsolved problem. They are the first cause of small bowel obstruction. Diagnosis is based on clinical evaluation, water-soluble contrast follow-through and computed tomography scan. For patients presenting no signs of strangulation, peritonitis or severe intestinal impairment there is good evidence to support non-operative management. Open surgery is the preferred method for the surgical treatment of adhesive small bowel obstruction, in case of suspected strangulation or after failed conservative management, but laparoscopy is gaining widespread acceptance especially in selected group of patients. "Good" surgical technique and anti-adhesive barriers are the main current concepts of adhesion prevention. We discuss current knowledge in modern diagnosis and evolving strategies for management and prevention that are leading to stratified care for patients.
Core tip: Adhesive disease is a consequence of all intra-peritoneal surgeries. We decided to carry out a systematic review about the adhesive small bowel obstruction because it is still difficult to make differential diagnosis and to understand the right time to operate and which surgical technique to perform. Besides there is a way to prevent major adhesive disease: "Good" surgical technique and anti-adhesive barriers are the main current concepts of adhesion prevention. We discuss all current knowledge in this field.
