Analysis of Bowel Viability Alterations in Patients with Acute Small Bowel Obstruction and Comorbidities: A Case Series

Case Report

Abstract

Acute small bowel obstruction frequently necessitates emergency surgical intervention. The primary determinant of surgical extent is the condition of intestinal viability, which can be compromised by vascular compression leading to acute ischemia. Viability is also affected by various factors such as patient age, obstruction location, and existing comorbidities. Numerous scales have been developed to predict viability changes, offering only a generalized pre-surgical assessment and forecasting necrotic intestinal changes. However, no current prognostic or diagnostic method can accurately predict intraoperative changes in the intestinal walls due to various influencing factors. Notably, comorbid pathologies pose a significant risk for complications, as they can substantially alter the condition of the intestinal walls, vessels, and circulation. This review presents three cases of comorbid patients with acute small bowel obstruction and intestinal necrosis, where intraoperative viability deterioration necessitated an extension of intestinal resection.

Objective: to educate surgeons on the risks associated with the progression of ischemic intestinal viability disorders in patients experiencing acute small bowel obstruction, particularly when comorbidities are present.