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

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dc.contributor.authorten Broek, Richard P G
dc.contributor.authorKrielen, Pepijn
dc.contributor.authorDi Saverio, Salomone
dc.contributor.authorCoccolini, Federico
dc.contributor.authorBiffl, Walter L
dc.contributor.authorAnsaloni, Luca
dc.contributor.authorVelmahos, George C
dc.contributor.authorSartelli, Massimo
dc.contributor.authorFraga, Gustavo P
dc.contributor.authorKelly, Michael D
dc.contributor.authorMoore, Frederick A
dc.contributor.authorPeitzman, Andrew B
dc.contributor.authorLeppaniemi, Ari
dc.contributor.authorMoore, Ernest E
dc.contributor.authorJeekel, Johannes
dc.contributor.authorKluger, Yoram
dc.contributor.authorSugrue, Michael
dc.contributor.authorBalogh, Zsolt J
dc.contributor.authorBendinelli, Cino
dc.contributor.authorCivil, Ian
dc.contributor.authorCoimbra, Raul
dc.contributor.authorDe Moya, Mark
dc.contributor.authorFerrada, Paula
dc.contributor.authorInaba, Kenji
dc.contributor.authorIvatury, Rao
dc.contributor.authorLatifi, Rifat
dc.contributor.authorKashuk, Jeffry L
dc.contributor.authorKirkpatrick, Andrew W
dc.contributor.authorMaier, Ron
dc.contributor.authorRizoli, Sandro
dc.contributor.authorSakakushev, Boris
dc.contributor.authorScalea, Thomas
dc.contributor.authorSøreide, Kjetil
dc.contributor.authorWeber, Dieter
dc.contributor.authorWani, Imtiaz
dc.contributor.authorAbu-Zidan, Fikri M
dc.contributor.authorDe’Angelis, Nicola
dc.contributor.authorPiscioneri, Frank
dc.contributor.authorGalante, Joseph M
dc.contributor.authorCatena, Fausto
dc.contributor.authorvan Goor, Harry
dc.date.accessioned2018-09-26T12:10:23Z
dc.date.available2018-09-26T12:10:23Z
dc.date.issued2018-06-19
dc.date.updated2018-09-26T12:10:23Z
dc.description.abstractAbstract Background Adhesive small bowel obstruction (ASBO) is a common surgical emergency, causing high morbidity and even some mortality. The adhesions causing such bowel obstructions are typically the footprints of previous abdominal surgical procedures. The present paper presents a revised version of the Bologna guidelines to evidence-based diagnosis and treatment of ASBO. The working group has added paragraphs on prevention of ASBO and special patient groups. Methods The guideline was written under the auspices of the World Society of Emergency Surgery by the ASBO working group. A systematic literature search was performed prior to the update of the guidelines to identify relevant new papers on epidemiology, diagnosis, and treatment of ASBO. Literature was critically appraised according to an evidence-based guideline development method. Final recommendations were approved by the workgroup, taking into account the level of evidence of the conclusion. Recommendations Adhesion formation might be reduced by minimally invasive surgical techniques and the use of adhesion barriers. Non-operative treatment is effective in most patients with ASBO. Contraindications for non-operative treatment include peritonitis, strangulation, and ischemia. When the adhesive etiology of obstruction is unsure, or when contraindications for non-operative management might be present, CT is the diagnostic technique of choice. The principles of non-operative treatment are nil per os, naso-gastric, or long-tube decompression, and intravenous supplementation with fluids and electrolytes. When operative treatment is required, a laparoscopic approach may be beneficial for selected cases of simple ASBO. Younger patients have a higher lifetime risk for recurrent ASBO and might therefore benefit from application of adhesion barriers as both primary and secondary prevention. Discussion This guideline presents recommendations that can be used by surgeons who treat patients with ASBO. Scientific evidence for some aspects of ASBO management is scarce, in particular aspects relating to special patient groups. Results of a randomized trial of laparoscopic versus open surgery for ASBO are awaited.
dc.identifier.citationWorld Journal of Emergency Surgery. 2018 Jun 19;13(1):24
dc.identifier.doihttps://doi.org/10.1186/s13017-018-0185-2
dc.identifier.urihttp://hdl.handle.net/1880/108015
dc.language.rfc3066en
dc.rights.holderThe Author(s).
dc.titleBologna 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
dc.typeJournal Article
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