Abstract
      Purpose: Follow the Nutrition Care Process
      Case: 82 yr old female with small bowel obstruction (SBO) who required total 
       parental nutrition (TPN)
      Previous hospital visit for SBO – noninvasive treatment and low fiber
      Hospitalized again for SBO secondary to adhesions
      PMH: Uterine cancer requiring hysterectomy
      TPN, lysis of adhesions, and right partial colectomy
      Discharged after 15 days on oral low fiber 
       Disease Description – Small Bowel 
       Obstruction
         The small intestine is a complex organ that plays a major role in the absorption of nutrients
         When contents of the intestine are blocked and unable to pass freely, this is considered a small 
           bowel obstructions (SBO).
         Signs & Symptoms
             Abdominal distention
             Constipation
             Vomiting
             Abdominal pain and cramps
             Nausea
             Diarrhea
        Disease Description – Causes
         Mechanical - characterized by the       Nonmechanical - factors that 
           narrowing of the intestinal lumen         interfere with the muscle action or 
             Inflammation or trauma to the bowel    innervation of the bowel
                                                      Paralytic ileus
               Neoplasms
                                                      Mesenteric embolus or thrombus
               Adhesions (Most common)
                                                      Hypokalemia 
               Hernias
             Volvulus (twisted bowel)
             Compression from outside the 
               intestinal tract
     Evidence-Based Nutrition 
     Recommendations
      Title: Reoperation on the Abdomen Encased in Adhesions
      Purpose: To determine the short and long-term outcomes after lysis of 
       adhesions
      Method: 40 patients who had recently undergone lysis of adhesions were 
       contacted to evaluate the outcome 
      Results: 1 postoperative death, 24 early complications. 28 out of 31 had 
       resolved SBO from the surgery
         Long-term outcomes: all subjects able to tolerate oral feedings
     Evidence-Based Nutrition 
     Recommendations
      Title: Burden of Adhesions in Abdominal & Pelvic Surgery: A Systematic Review 
       and Metanalysis
      Purpose: To estimate the burden of complications associated with abdominal 
       adhesions
      Method: Analysis of 196 papers from PubMed, Embase, and Central which 
       reported incidences of adhesion related complications
      Results: Increase risk of developing a SBO in open abdominal/pelvic surgery. 
       Adhesive SBO associated with longer hospital stays.