Impact of barometric pressure on adhesive small bowel obstruction: a retrospective study

Abstract Background Adhesive small bowel obstruction (ASBO) is one of the most common causes of postoperative morbidity. According to Boyle’s law, decreased barometric pressure causes the volume of intestinal gas to expand. We aimed to elucidate the relationship between barometric pressure and ASBO. Methods We divided 215 admissions of 120 patients with ASBO into three groups: fasting group with response to fasting (n = 51); decompression group with successful treatment of gastrointestinal decompression (n = 104); and surgery group that required emergency or elective surgery to treat ASBO (n = 60). We compared and examined clinical backgrounds, findings on admission, and barometric pressure during the peri-onset period (29 days: from 14 days before to 14 days after the onset of ASBO). Results There were significant difference among the three groups in gender, history of ASBO, hospital length of stay, and barometric pressure on the onset day of ASBO. Barometric pressure on the onset day was significantly higher in the fasting group than in the decompression group (p = 0.005). During pre-onset day 5 to post-onset day 2, fluctuations in the barometric pressure in the fasting and decompression groups showed reciprocal changes with a symmetrical axis overlapping the median barometric pressure in Matsumoto City, and the fluctuations tapered over time after onset. In the fasting group, the barometric pressure on the onset day was significantly higher than that on pre-onset days 14, 11, 7, 4, 3, 2; post-onset days 3, 10; and the median pressure in Matsumoto City. Conversely, in the decompression group, the barometric pressure on the onset day was lower than that on pre-onset days 14, 5 − 2; post-onset days 1, 2, 7, 8, 11, 13, 14; and the median pressure in Matsumoto City. In the surgery group, the barometric pressure on the onset day was equivalent to those on the other days. Conclusion ASBO with response to conservative treatment is vulnerable to barometric pressure. Additionally, ASBO successfully treated with fasting and decompression is associated with a different barometric pressure on the onset day and reciprocal fluctuations in the barometric pressure during the peri-onset period.

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Adhesive Small Bowel Obstruction Protocol in Geriatric Patients

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2019.08.200 ◽

2019 ◽

Vol 229 (4) ◽

pp. S87

Author(s):

Jose A. Aldana ◽

Javier E. Rincon ◽

Ricardo A. Fonseca ◽

Rohit K. Rasane ◽

Christina X. Zhang ◽

...

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Geriatric Patients ◽

Adhesive Small Bowel Obstruction

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Sex differences in non‐strangulated postoperative adhesive small bowel obstruction: A retrospective cohort study

ANZ Journal of Surgery ◽

10.1111/ans.17103 ◽

2021 ◽

Author(s):

Yuta Yamamoto ◽

Yusuke Miyagawa ◽

Masato Kitazawa ◽

Makoto Koyama ◽

Satoshi Nakamura ◽

...

Keyword(s):

Sex Differences ◽

Cohort Study ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Adhesive Small Bowel Obstruction

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Adhesive Small Bowel Obstruction and the six w’s: Who, How, Why, When, What, and Where to diagnose and operate?

Scandinavian Journal of Surgery ◽

10.1177/1457496920982763 ◽

2021 ◽

pp. 145749692098276

Author(s):

M. Podda ◽

M. Khan ◽

S. Di Saverio

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Conservative Management ◽

Bowel Ischemia ◽

Current Evidence ◽

First Episode ◽

Adhesive Small Bowel Obstruction ◽

Highly Effective

Background and Aims: Approximately 75% of patients admitted with small bowel obstruction have intra-abdominal adhesions as their cause (adhesive small bowel obstruction). Up to 70% of adhesive small bowel obstruction cases, in the absence of strangulation and bowel ischemia, can be successfully treated with conservative management. However, emerging evidence shows that surgery performed early during the first episode of adhesive small bowel obstruction is highly effective. The objective of this narrative review is to summarize the current evidence on adhesive small bowel obstruction management strategies. Materials and Methods: A review of the literature published over the last 20 years was performed to assess Who, hoW, Why, When, What, and Where diagnose and operate on patients with adhesive small bowel obstruction. Results: Adequate patient selection through physical examination and computed tomography is the key factor of the entire management strategy, as failure to detect patients with strangulated adhesive small bowel obstruction and bowel ischemia is associated with significant morbidity and mortality. The indication for surgical exploration is usually defined as a failure to pass contrast into the ascending colon within 8–24 h. However, operative management with early adhesiolysis, defined as operative intervention on either the calendar day of admission or the calendar day after admission, has recently shown to be associated with an overall long-term survival benefit compared to conservative management. Regarding the surgical technique, laparoscopy should be used only in selected patients with an anticipated single obstructing band, and there should be a low threshold for conversion to an open procedure in cases of high risk of bowel injuries. Conclusion: Although most adhesive small bowel obstruction patients without suspicion of bowel strangulation or gangrene are currently managed nonoperatively, the long-term outcomes following this approach need to be analyzed in a more exhaustive way, as surgery performed early during the first episode of adhesive small bowel obstruction has shown to be highly effective, with a lower rate of recurrence.

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