SURGICAL PROCEDURES AND CLINICAL MANAGEMENT IN THE TREATMENT OF ACUTE OBSTRUCTIVE ABDOMEN

Abstract

Acute obstructive abdomen, primarily manifested by intestinal obstruction, is one of the most frequent and complex surgical emergencies. The condition is classified as mechanical (due to causes such as adhesions, bands, or neoplasms) and functional (pseudo-obstruction of the intestine). The management of these patients requires a careful decision between conservative management and immediate surgical intervention. This work, a narrative literature review, sought to synthesize and analyze contemporary scientific evidence on surgical approaches and clinical management. Contrast-enhanced computed tomography (CT) is the gold standard for diagnosis. The literature indicates that the rigorous application of Bologna guidelines reduces complications in obstruction due to adhesions (ASBO). In the context of malignant bowel obstruction (MBO), a multimodal approach is adopted, where aggressive medical management (including corticosteroids, octreotide, and stents) is a valid option, although surgery may improve oral feeding in selected cases. The discussion emphasizes that the surgical decision should be individualized, especially in malignant cases, and the prognosis depends on the speed of recognition of ischemic distress and the application of early decompression protocols, whether surgical, endoscopic, or pharmacological.