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Small bowel obstruction: blockage in small intestine. Adhesions are the most common cause. Accounts for 300,000 hospitalizations in the US annually, and 20% of emergency surgical procedures in patients with abdominal pain. High morbidity and mortality. Average hospital stay of 8 days. 30-day readmission rate of 16%. In-hospital mortality rate of 3%. Costly diagnosis: more than $2 billion spent on admissions for adhesion-related disease in the United States. Clinical presentation: variable, includes abdominal pain, vomiting, constipation, nausea, and abdominal distention. Management. Operative: important if signs of ischemia, peritonitis, or strangulation. Conservative: includes bowel rest, nasogastric decompression, serial examinations, and a water-soluble contrast challenge. Majority of patients (65-80%) with SBO due to adhesions can be successfully managed with non-operative treatment. Wide institutional variation exists with respect to the decision on admitting service. Aim and Objective To understand the differences in admitting service (medicine or surgery) in patients with SBO on morbidity and length of stay in a large academic hospital vs a community hospital.

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small bowel obstruction, outcomes, academic hospital, community hospital


Emergency Medicine


The Embark Capstone Colloquium at the Oakland University William Beaumont School of Medicine, Rochester Hills, MI, May 2, 2022.

Differences in Small Bowel Obstruction Outcomes in an Academic vs Community Hospital.