PAEA Surgery End Of Rotation (EOR) Practice Exam

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What is the first-line treatment for a small bowel obstruction?

Immediate surgical intervention
Resuscitation, NG tube decompression, and bowel rest
Antibiotic therapy and patient education
Pain management and discharge planning

The correct answer is: Resuscitation, NG tube decompression, and bowel rest

The first-line treatment for a small bowel obstruction involves resuscitation, decompression through a nasogastric (NG) tube, and bowel rest. This conservative management approach is usually preferred initially, especially in cases where the obstruction is partial and the patient is stable. Resuscitation is crucial to address any fluid and electrolyte imbalances that may have arisen due to vomiting or lack of absorption in the obstructed bowel. NG tube decompression helps relieve pressure in the gastrointestinal tract by allowing gastric contents to drain, thereby reducing the risk of perforation and alleviating symptoms such as nausea and abdominal pain. Bowel rest is necessary to prevent further irritation of the bowel. It allows the gastrointestinal tract to recover and can sometimes lead to spontaneous resolution of the obstruction without the need for surgical intervention. Only if these conservative measures fail or if there are signs of complications like perforation, ischemia, or complete obstruction, immediate surgical intervention may become necessary. Therefore, the chosen treatment strategy prioritizes non-invasive management before considering more invasive options.