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Use of the Long Tube in the Management of Patients With Small-Intestinal Obstruction due to Adhesions
Philip J. Wolfson, MD;
Joel J. Bauer, MD;
Irwin M. Gelernt, MD;
Isidore Kreel, MD;
Arthur H. Aufses, Jr, MD
Arch Surg. 1985;120(9):1001-1006.
Abstract
• A retrospective analysis was performed of all patients admitted to our hospital over a six-year period with a diagnosis of small-intestinal obstruction due to adhesions, to assess the efficacy of treatment with long-tube decompression. Of 127 episodes of obstruction, two thirds responded to nonoperative treatment. Factors that were associated with a greater likelihood of success with long-tube decompression included incomplete obstruction, recurrent obstruction, and passage of the tube beyond the pylorus. Clinical findings were relatively reliable as diagnostic indicators of strangulation. The overall mortality was 1.5%, with no deaths due to a delay in operative intervention. A trial of long-tube decompression is recommended in patients presenting with a diagnosis of small-intestinal obstruction due to adhesions in the absence of clinical evidence of strangulation.
(Arch Surg 1985;120:1001-1006)
Author Affiliations
From the Department of Surgery, Jefferson Medical College, Philadelphia (Dr Wolfson); and the Department of Surgery, Mount Sinai Medical Center, New York (Drs Bauer, Gelernt, Kreel, and Aufses).
Footnotes
Accepted for publication May 8, 1985.
Reprint requests to Department of Surgery, Jefferson Medical College, 1025 Walnut St, Philadelphia, PA 19107 (Dr Wolfson).
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