SBO can be classified according to completeness: Partial vs. Complete (or high grade vs. low grade), according to etiology: Adhesional vs. Non-adhesional, according to timing: Early vs. Late (>30 days after surgery). The most important risk factor for adhesive SBO is the type of surgery and extent of peritoneal damage. Surgeries of the colon and rectum are associated with a higher risk of adhesion-related

problems [14]. Total colectomy AUY-922 price with ileal pouch-anal anastomosis is the procedure with the highest incidence for adhesion-related problems with an overall incidence of SBO of 19.3%. Other high-risk procedures include gynecologic surgeries (11.1%) and open colectomy (9.5%). Other possible risk Tideglusib purchase factors include age younger than 60 years, previous laparotomy within 5 years, peritonitis, multiple laparotomies,

emergency surgery, omental resection, and penetrating abdominal trauma, especially gunshot wounds [15–18]. The number of prior episodes is the strongest predictor of recurrence; in fact ASBO recurred after 53% of initial episodes and 85% or more of second, third, or later episodes in the experience of Barkan et al. Recurrence occurred selleck chemicals llc sooner and more frequently in patients managed nonoperatively than in patients managed operatively [19]. With growing numbers of previous episodes of SBO requiring adhesiolysis, the risk for future re-admission for SBO

increases, thus nonsurgical management of the initial episode has been 6-phosphogluconolactonase advocated as a risk factor for recurrence [20]. Age younger than 40 years, the presence of matted adhesions, and surgical complications during the surgical management of the first episode as independent risks for recurrence [21]. Williams et al. [22] in a retrospective review of 329 patients (487 admissions) demonstrated that operatively treated patients had a lower frequency of recurrence (26.8% vs 40.5% P < 0.009) and a longer time interval to recurrence (411 vs 153 days P < 0.004); however, they also had a longer hospital stay than that of patients treated nonoperatively (12.0 vs 4.9 days; P < 0.0001). There was no significant difference in treatment type or in incidence or type of prior surgery among patients with early and late small bowel obstruction. The authors have also reported [23] early postoperative mortality of 3% and long-term mortality of 7% with the following independent risk factors: age >75 years old, medical complications, and a mixed mechanism of obstruction. Prevalence of medical and surgical morbidity was 8% and 6%, respectively.