Does Amount of Intra-abdominal Fluid on CT May Predict Failure of Non-operative Management in Patients with Small Bowel Obstruction?

Most of the small bowel obstruction (SBO) are caused by postoperative adhesions and resolved spontaneously. Findings of intra-abdominal fluid on abdominal computerized tomography (CT) may predict failure of non-operative management (NOM). In this study, we aim to evaluate the correlation between the amount of intra-abdominal fluid and NOM failure. Data of all the patients admitted with adhesional SBO between years 2015 and 2019 were retrospectively collected. Only those who underwent CT as part of the management were included in the study. Patients were divided in 2 groups. Group I included patients that failed NOM, and patients with spontaneous resolution of SBO were included in group II. Both groups were compared. Overall, 197 patients met the inclusion criteria. Group I included 78 patients. The rest of the patients were included in group II. No differences were observed in demographics, number of previous abdominal operations, laboratory tests, CT findings of increased bowel diameter, and presence of fecal sign. In multivariate analysis, only a large amount of intra-abdominal fluid remained significant. NOM failure is more prevalent in patients with adhesional SBO with large amounts of intra-abdominal fluid on CT.