Gunadi, Ezra Endria and Mughni, Abdul (2025) Comparison of Outcome Between Non-Operative and Operative Management in Patients with Partial Small Bowel Obstruction at Dr. Kariadi Hospital, Semarang in January 2024-December 2024. Masters thesis, UNIVERSITAS DIPONEGORO.

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Abstract

Background: Small bowel obstruction (SBO) represents a frequent clinical scenario in general surgery, accounting for approximately 12% of surgical admissions and over 300,000 operative interventions annually. The predominant etiology is postoperative adhesions, particularly in individuals with a history of abdominal surgery, followed by hernias and neoplastic processes.¹ However, emerging literature indicates a notable prevalence of adhesions even in patients without any prior surgical history, suggesting congenital origins or subclinical inflammatory episodes as possible underlying causes.² Over the past decade, management strategies for SBO have evolved considerably, with increasing emphasis on conservative, non-operative approaches. Non-operative treatment has demonstrated success in approximately 70% of ASBO cases.² Surgical intervention is generally reserved for patients presenting with clinical signs of peritonitis, strangulation, or ischemic bowel. The optimal duration of conservative therapy remains a subject of clinical debate; however, a 72-hour observation period is commonly accepted as a reasonable trial duration. Method: This study employed a retrospective, cross-sectional, analytic design, conducted at Dr. Kariadi General Hospital over the period of January to December 2024, and involved 167 patients. Inclusion criteria were: (1) Patients diagnosed with partial SBO in a previously non-operated (virgin) abdomen who presented to the hospital's emergency department during the study period, and (2) individuals aged 18 years or older. Exclusion criteria consisted of: (1) Complete small bowel obstruction, (2) colonic obstruction, (3) any history of abdominal surgery, and (4) age below 18 years. Data Collection: Patient data were extracted from the hospital’s electronic medical record (EMR) system. The study documented all cases of SBO without prior abdominal surgical history, detailing whether patients underwent non-operative management (NOM) or surgical intervention. Data on hospital length of stay (LOS) were also compiled to compare outcomes between treatment modalities.

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