Two patients with adhesional SBO were managed conservatively.
9,17 Meyerson et al managed a patient with
adhesional SBO conservatively from 31 weeks’ gestation up
until delivery at 36 weeks.17 Phillips et al managed a
patient with SBO conservatively at 26 weeks’ gestation,
resolving the acute episode.9 The patient continued to have
episodes of incomplete obstruction throughout pregnancy
and was managed with instigation of an elemental diet
until she delivered at 38 weeks. In both cases, there was
no fetal loss or maternal mortality.
Diagnosis of SBO can be difficult to make as symptoms
are often attributed mistakenly to the pregnancy and there
can be a reluctance to request plain films owing to the
risks of ionising radiation. Both of these factors can lead to
a delay in diagnosis and initiating treatment. Previous literature
reviews have placed great importance on aggressive
management with prompt laparotomy once a diagnosis of
SBO has been made, with no role for conservative treatment,
3,4 part of this argument being that the aetiology of
the SBO cannot be determined until a laparotomy has been
performed.