Incidence of Subacute Intestinal Obstruction in Adult Population Following Abdominal Surgery and Their Response to Conservative Management

Abstract

Background: Subacute intestinal obstruction (SAIO) is a common postoperative complication following abdominal surgery, frequently caused by adhesions, bowel edema, anastomotic narrowing, or motility disturbances. It contributes to morbidity, prolonged hospitalization, and increased healthcare costs. Conservative management remains the first-line treatment in hemodynamically stable patients. Objective: To determine the incidence of subacute intestinal obstruction in adults following abdominal surgery and to evaluate their response to conservative management. Methods: Between January 2021 and January 2024, 200 adult patients who had been diagnosed with SAIO following abdominal surgery participated in a retrospective observational study. Hospital records were used to gather information on the patient's demographics, kind of prior surgery, clinical presentation, imaging results, length of symptoms, results of treatment, and need for surgery. Student's t-test and the chi-square test were used for statistical analysis. Statistical significance was defined as a p-value of less than 0.05. Results: The age group 41–60 years old had the highest incidence (42%) among 200 patients. In 58% of cases, men were involved. The most frequent antecedent procedures were gynecological surgery (24%) and colorectal surgery (30%). 154 patients (77%) responded well to conservative treatment, but 46 patients (23%) needed surgery. When presenting within 48 hours of the onset of symptoms, success rates were higher (86%) than when presenting later (61%) (p=0.003). The most common cause (68%) was adhesive blockage. Successfully conservatively managed patients had a considerably shorter mean hospital stay (4.6 ±1.8 days) compared to surgically managed patients (9.2 ±3.1 days) (p<0.001). Conclusion: SAIO after abdominal surgery is frequently related to postoperative adhesions. Conservative treatment is effective in the majority of stable patients, especially those presenting early. Timely diagnosis, close monitoring, and careful patient selection are essential to reduce unnecessary surgery and improve outcomes.