Protocolo diagnóstico y terapéutico de la obstrucción intestinal en urgencias

Abstract

Bowel obstruction is a common disease in emergency departments. Computed tomography (CT) plays an important role in the diagnosis and prediction of a surgical intervention whereas the use of oral contrast has been demonstrated to predict the success of conservative management. It is recommended to perform an abdominal x-ray on all patients suspected of having obstruction. In the case of an uncertain diagnosis, it is advised to perform a CT scan with intravenous contrast. If there are no signs of ischemia, the use of oral contrast after decompression with a nasogastric tube is safe. If the contrast does not reach the colon after 12hours, conservative management is considered to have failed and surgical management should be considered.