Regarding adhesive intestinal obstruction, TRUE is ?
Ans. is 'a' i.e., Avoid surgery for initial 48-72 hours There are three main measures in the tit of acute intestinal obstruction. These are 1) Gastro intestinal drainage (Nasogastric suction) 2) Fluid and electrolyte replacement 3) Surgery for relief of obstruction The first two steps are always necessary prior to the surgical relief of obstruction. Surgical treatment is necessary for most cases of intestinal obstruction, but it should always be delayed until resuscitation is complete. The timing of surgical intervention is dependent on clinical picture. The classical clinical advice on a case of unrelieved intestinal obstruction is that "Sun should not both rise and set" i.e., the operative procedure should not be delayed beyond 24 hrs. But, there are ceain exceptions to this rule. In some cases operation is delayed in the hope of spontaneous resolution. In adhesive intestinal obstruction, usually occuring after surgery the upto 72 hours in the hope of spontaneous resolution. In these cases continued radiological evidence of obstruction. Also know the four types of obstruction, where operation should be done a) Stangualtion b) Closed loop obstuction c) Colon obstruction d) Early simple mechanical obstruction More about adhesive intestinal obstruction - Commonest cause of intestinal obstruction, usually follows pelvic operations Obstruction due to postoperative adhesions commonly involve the lower small bowel.
Avoid surgery for initial 48-72 hours
Never operate
Operate after minimum 10 days of conservative treatment
Immediate operation