Operative versus Non-Operative Management of Adhesive Small Bowel Obstruction: A Prospective Study at Tobruk Medical Center

Abstract

Adhesive small bowel obstruction (ASBO) is a common complication following abdominal surgery, affecting approximately 95% of patients with prior abdominal operations. This study aimed to determine the optimal timing for surgical intervention in ASBO patients and improve clinical management. A prospective comparative study was conducted at the General Surgery Department of Tobruk Medical Centre. Thirty patients with ASBO were randomly assigned to two equal groups: Group A (conservative, non-operative care) and Group B (operative care). In the operative group, 13 patients (86.6%) underwent early exploratory laparotomy. In the conservative group, 8 patients (53.3%) required surgery due to failure of conservative management. The most common prior procedure in both groups was open appendectomy, followed by caesarean section. Recurrence of SBO was significantly higher in the conservative group (7 patients, 46.7%) compared to the operative group (2 patients, 13.3%) (p = 0.0042). Early surgical intervention within 24 hours of admission significantly reduces recurrence rates in ASBO patients