| Title： | Chinese emergency expert consensus on diagnosis and treatment of closed loop small bowel obstruction |
| Edition： | Original |
| Classification： | Experts consensus |
| Field： | Diagnosis and Treatment |
| Countries and regions： | China |
| Guidelines users： | General surgeons and emergency physicians |
| Evidence classification method： | This expert consensus adopts the GRADE Collaboration's guideline grading standard to grade the evidence, and adopts the internationally accepted modified Delphi method to organize expert voting to revise and reach the relevant recommendations. The voting opinions were divided into 6 levels: Level 1: complete agreement (100%); Level 2: basic agreement (80%); Level 3: partial agreement (60%); Level 4: partial opposition (40%); Level 5: more opposition (20%); Level 6: complete opposition (0). Recommendation level is divided into 2 levels of strong recommendation and weak recommendation according to the votes of experts: "totally agree" with more than 80% of votes is strong recommendation; "totally agree" + "basically agree" with more than 80% of votes is weak recommendation. |
| Development unit： | Affiliated Hospital of Qingdao University；Fujian Medical University Union Hospital;The First Affiliated Hospital of Army Military Medical University;The Fourth Medical Center of the Chinese People's Liberation Army General Hospital |
| Registration time: | 2024-09-04 |
| Registration number： | PREPARE-2024CN392 |
| Purpose of the guideline: | Closed loop small bowel obstruction is a common surgical acute abdomen, a special type of small bowel obstruction, which requires early diagnosis and early intervention. Once missed diagnosis or delayed treatment, it will lead to serious complications such as intestinal necrosis, intestinal perforation, acute diffuse peritonitis, and even death. Due to the different degree of obstruction and ischemia, in addition to the classic symptoms of "pain, vomiting, distension, closure" of intestinal obstruction, there are often abdominal mass, intractable shock and other symptoms. Due to the lack of systematic imaging of occlusion-loop ileus, current diagnosis relies heavily on interactive film review and multidisciplinary discussion between senior surgeons and radiologists. Surgical removal of occlusive loop and resection of intestinal loop with ischemic necrosis are currently common clinical treatment strategies, which have basically reached a consensus in the industry. However, the timing of surgery, the choice of surgical methods, and the individualization of conservative plans remain to be further discussed. |
