A Review of the Conservative Management of Adhesive Intestinal Obstruction in Low Resource Centres

Abstract

Adhesions are common following abdominal surgeries usually after about a few years from the previous Surgical procedures. This review aims to summarize the latest evidence and clarify previous uncertainties, specifically regarding the duration of conservative treatment, and the reliability of conservative management in low-resource countries like Nigeria. Previous pieces of literature were searched online and current reported management options were explored. The management options for adhesive intestinal obstruction AIO could be non-operative (conservative management) or operative treatment. A trial of non-operative management is recommended in all patients except those with signs of peritonitis, strangulation, or bowel ischemia which would have been diagnosed during physical examination and imaging. However, in poor resource countries where prompt access to imaging is not feasible, a surgical option often results from failed conservative treatment. Whereas such patients were candidates for surgical treatment ab into where resources were available. Relapse and recurrence are universal in patients with AIO; once an adhesion, always an adhesion. As the number of (re)admissions increases, recurrence risk increases and the disease‐free interval between recurrences decreases. This is one of the banes of AIO; more is needed to be done to reduce the incidence and re-occurrence, especially in low-resource countries.