EP.FRI.500 Establishing a protocol of management of acute bowel obstruction in a tertiary hospital in the Middle East

Abstract

Abstract Aim To establish a protocol of management of acute bowel obstruction in a tertiary hospital in the Middle East. Method An online search in PubMed, Cochrane reviews and Google Scholar for the period between 2010 and 2020 was performed to identify all published guidelines and recommendations for the management of acute bowel obstruction including the keywords small/large bowel or intestinal obstruction, adhesive obstruction, complete/ partial obstruction and conservative/ surgical management of bowel obstruction. Results A protocol of management of acute bowel obstruction has been developed, reviewed and approved by different concerned departments in the hospital. The indicators to monitor the implementation of the protocol had been approved by the Quality and Risk Management Committee of the hospital. The protocol is divided into 7 sections. These sections include:1) ER assessment with all essential clinical, laboratory and radiological investigations required going hand in hand with resuscitation, hydration, pain control and antibiotic prophylaxis.2) Surgical assessment by senior trainee who will liaise with consultant surgery on call. 3) Radiological assessment guidelines done by senior Radiologist to review the CT scan. 4) Admission criteria. 5) Risk prediction scorings with involvement of critical care team if indicated. 6) Surgical management guidelines with rapid access to operating theatre if indicated. 7) Non- surgical management guidelines including conservative, radiological and endoscopic management. Conclusion Multidisciplinary team approach is essential for the management of acute bowel obstruction. Hospital agreed guidelines and protocols can reduce the significant morbidity and mortality associated with common clinical conditions hence improving patient’s care.