September 1985

Use of the Long Tube in the Management of Patients With Small-Intestinal Obstruction due to Adhesions

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).

Arch Surg. 1985;120(9):1001-1006. doi:10.1001/archsurg.1985.01390330013002

• 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)