TPTh 2.10 A Four-Year Retrospective Service Evaluation of Recurrence in Adhesive Small Bowel Obstruction: A Comparison of Surgical and Non-Surgical Management
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2026
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Abstract
Abstract Adhesive small bowel obstruction is a major cause of emergency surgical admissions and accounts for nearly half of all emergency laparotomies in the UK. Recurrence remains a significant challenge, with reported rates ranging from 2.2% to 34.9%. Although non-operative management is recommended for stable patients, the optimal strategy to reduce recurrence is still debated. This study evaluates recurrence patterns and outcomes in a four-year cohort. A retrospective cohort analysis included 69 adults with clinically and radiologically confirmed ASBO. Of these, 46 patients (66.7%) were treated conservatively, and 23 patients (33.3%) underwent surgery. Collected data encompassed demographics, comorbidities, previous abdominal operations, laboratory markers, imaging findings, management strategy, time to surgery, and outcomes. Primary endpoints were recurrence and time-to-recurrence; secondary outcomes included mortality, length of stay, ICU admission, and bowel resection. Fisher’s exact test and Kaplan–Meier analysis used. Recurrence occurred in 15 of 46 conservatively managed patients (32.6%) compared with 2 of 23 surgically managed patients (8.7%), representing a significant association between management approach and recurrence (p = 0.039). Kaplan–Meier analysis showed no significant difference in recurrence-free survival (p = 0.210), likely due to the low recurrence number in the operative group. Comorbidity burden was the only significant predictor of initial management, with more comorbid patients more likely to receive conservative treatment. Overall, operative management was associated with a lower recurrence rate. Improved standardization of imaging, consistent use of water-soluble contrast, and clearer limits on conservative therapy duration may enhance outcomes.
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| Authors | Mahmoud Elkadi, Altaf Haji, Sameur Rahman, Corinna Dunzendorfer, Beth Woodward, Aditi Shrestha, Zain Khan |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag087.435
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| URL | |
| Keywords | Keywords not found |
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