REBEL Core Cast 94.0 - By Anand Swaminathan - January 25, 2023
Take Home Points
- SBO should be considered in all patients presenting with abdominal pain particularly if they have a prior abdominal surgical history
- Patients with SBO often have non-specific signs and symptoms. There is no history or physical exam feature that rules out the disease
- Lactate elevation is a late finding in SBO. A normal lactate does not rule out the diagnosis
- Plain X-rays perform poorly in making or ruling out the diagnosis. CT is the most widely accepted imaging modality but US (both formal and ED) has better performance characteristics
- Patients with SBO should have an emergent surgical consultation and treatment should start with good supportive care (IV fluids, electrolyte repletion, antiemetics)
- Patients with hypotension, hypoperfusion or frank sepsis from an SBO should be aggressively resuscitated and optimized for operative management