Gastrografin vs Conservative Management for ASBO

Adhesive small bowel obstruction is a common surgical emergency, causing high morbidity and sometimes even mortality. The adhesions causing such bowel obstructions are typically the footprints of previous abdominal surgical procedures. Post-operative adhesions are the leading cause of small bowel obstruction, accounting for 60% of cases.Although ASBO is a common condition, the prevention and treatment is often characterized by surgeons’ personal preferences rather than standardized evidence- based protocols. ASBO causes considerable harm, resulting in 16 days of hospitalization on average, after surgical treatment and an in-hospital mortality rate of 3% per episode. There is a large amount of conflicting and low- quality evidence in publications regarding treatment of ASBO.Hence the World Society of Emergency Surgery postulated an evidence- based guidelines the Bologna Guidelines for the diagnosis and management of adhesive small bowel obstruction. In the absence of signs that require emergent surgical exploration (i.e., peritonitis, strangulation or bowel ischemia), non-operative management is the treatment strategy of choice.The aim of the study is to compare the non-operative strategies in terms of efficacy and hospital stay.