Management

The management of mechanical bowel obstruction involves:

• decompression via nasogatric/long tube: - as part of intial resuscitation - treatment for partial obstruction which may resolve or allow time to prepare bowel for elective surgery
  
  
• volume and electrolyte replacement: - the longer the period of obstruction, the more fluid replacement is required to avoid intraoperative hypotension and its sequelae - MI, CVA, renal failure
  
  
• surgery for the following indications: - complete small bowel obstruction - there is no reliable way of clinically differentiating a simple from a strangulating complete small bowel obstruction. Hence, early operation is indicated to avoid bowel resection. - closed loop - complete colonic obstruction with competent ileocaecal valve and progressively dilating caecum.