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History and physical examination are essential to identify signs of bowel ischemia as this indicates a need for urgent surgical exploration. Another critical aspect of evaluation includes establishing the underlying cause for obstruction and distinguishing between adhesive and non\u2010adhesive etiologies as adhesive SBO (ASBO) can be managed non\u2010operatively in 70\u201390% of patients. A patient with a history of abdominopelvic surgery along with one or more cardinal features of obstruction should be suspected to have ASBO until proven otherwise. Triad of severe pain, pain out of proportion to the clinical findings, and presence of an abdominal scar suggest possible closed\u2010loop obstruction. Computed tomography has higher sensitivity and specificity compared to plain films and is recommended by the Bologna guidelines. Correcting fluid and electrolyte imbalance is an initial crucial step to mitigate severe hypovolemia. Patients should proceed with surgery if symptoms of bowel compromise are present, or if symptoms do not resolve or have worsened. Surgery is indicated in patients with ischemia, strangulation, perforation, peritonitis, or failure of non\u2010operative treatment. With advances in minimal access technology and increasing experience, laparoscopic adhesiolysis is recommended. Mechanical adhesion barriers are an effective measure to prevent adhesion formation.<\/jats:p>","DOI":"10.1002\/ams2.587","type":"journal-article","created":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T02:53:31Z","timestamp":1604544811000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":112,"title":["Adhesive small bowel obstruction \u2013 an update"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3101-2269","authenticated-orcid":false,"given":"Jia Wei Valerie","family":"Tong","sequence":"first","affiliation":[{"name":"Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pravin","family":"Lingam","sequence":"additional","affiliation":[{"name":"Department of General Surgery Tan Tock Seng Hospital Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishalkumar Girishchandra","family":"Shelat","sequence":"additional","affiliation":[{"name":"Department of General Surgery Tan Tock Seng Hospital Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,4]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31827019de"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.14132872"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.4103\/0971-3026.190426"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2017.01.021"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-017-0566-9"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-016-0109-y"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-004-7382-8"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-018-0208-z"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-013-0591-8"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2168.2000.01530.x"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2013.09.034"},{"key":"e_1_2_12_13_1","first-page":"191","article-title":"Adhesive small bowel obstruction: predictive value of oral contrast administration on the need for surgery","volume":"96","author":"Perea Garc\u00eda J","year":"2004","journal-title":"Rev. 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