{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T21:41:06Z","timestamp":1771018866741,"version":"3.50.1"},"reference-count":10,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2009,9,9]],"date-time":"2009-09-09T00:00:00Z","timestamp":1252454400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2009,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The majority of small bowel obstructions (SBO) are the result of adhesions caused by a previous abdominal operation. On rare occasions, adhesional SBO occurs in the absence of such an operation. Our objective was to describe the management, findings, and outcomes of unexplained adhesional SBO (UA\u2010SBO) and examine whether preoperative diagnostic uncertainty leads to delays in therapy and complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The medical records of all adhesional SBO patients admitted to the Massachusetts General Hospital between January 1, 1997 and December 31, 2007 were screened. UA\u2010SBO records were reviewed in detail. Each UA\u2010SBO patient was matched with an adhesional SBO patient with abdominal surgical history (SH\u2010SBO) according to gender, age (\u00b17 years), white blood cell count (\u00b13000\/mm<jats:sup>3<\/jats:sup>), time interval from the onset of symptoms to the time of admission (\u00b124 h), and year of admission (\u00b14 years). Outcomes included time from admission to operation, morbidity, mortality, and length of hospital stay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1,036 patients with adhesional SBO, 34 (3.3%) had UA\u2010SBO. Adhesiolysis was sufficient in 31 patients, whereas 3 required an enterectomy. UA\u2010SBO patients were similar in terms of demographics, clinical presentation, and initial laboratory tests with SH\u2010SBO patients. There was no difference in any of the outcomes between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this study of UA\u2010SBO, diagnostic delays were not found and patient outcomes were similar to those of patients with SH\u2010SBO.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-009-0200-6","type":"journal-article","created":{"date-parts":[[2009,9,8]],"date-time":"2009-09-08T19:53:20Z","timestamp":1252439600000},"page":"2368-2371","source":"Crossref","is-referenced-by-count":15,"title":["Adhesional Small Bowel Obstruction in the Absence of Previous Operations: Management and Outcomes"],"prefix":"10.1002","volume":"33","author":[{"given":"Muhammad U.","family":"Butt","sequence":"first","affiliation":[{"name":"Division of Trauma, Emergency Surgery and Surgical Critical Care Massachusetts General Hospital and Harvard Medical School 165 Cambridge Street, Suite 810 02114 Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George C.","family":"Velmahos","sequence":"additional","affiliation":[{"name":"Division of Trauma, Emergency Surgery and Surgical Critical Care Massachusetts General Hospital and Harvard Medical School 165 Cambridge Street, Suite 810 02114 Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikos","family":"Zacharias","sequence":"additional","affiliation":[{"name":"Division of Trauma, Emergency Surgery and Surgical Critical Care Massachusetts General Hospital and Harvard Medical School 165 Cambridge Street, Suite 810 02114 Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hasan B.","family":"Alam","sequence":"additional","affiliation":[{"name":"Division of Trauma, Emergency Surgery and Surgical Critical Care Massachusetts General Hospital and Harvard Medical School 165 Cambridge Street, Suite 810 02114 Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"de Moya","sequence":"additional","affiliation":[{"name":"Division of Trauma, Emergency Surgery and Surgical Critical Care Massachusetts General Hospital and Harvard Medical School 165 Cambridge Street, Suite 810 02114 Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R.","family":"King","sequence":"additional","affiliation":[{"name":"Division of Trauma, Emergency Surgery and Surgical Critical Care Massachusetts General Hospital and Harvard Medical School 165 Cambridge Street, Suite 810 02114 Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,9,9]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(98)09337\u20104"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(16)44234-9"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002\u20109610(00)00407\u20104"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002\u20109610(73)80123\u20100"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2007.09.082"},{"key":"e_1_2_5_7_2","first-page":"255","article-title":"Incarcerated internal hernia of the small intestine through a breach of the broad ligament: two cases and a literature review","volume":"11","author":"Agresta F","year":"2007","journal-title":"JSLS"},{"key":"e_1_2_5_8_2","first-page":"107","article-title":"Red herring: a rare cause of small bowel obstruction","volume":"4","author":"Smith GH","year":"2006","journal-title":"Am Surg"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/87050272"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00595\u2010004\u20102821\u20106"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sle.0000183258.34926.59"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-009-0200-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-009-0200-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-009-0200-6","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T15:15:59Z","timestamp":1703603759000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-009-0200-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,9,9]]},"references-count":10,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2009,11]]}},"alternative-id":["10.1007\/s00268-009-0200-6"],"URL":"https:\/\/doi.org\/10.1007\/s00268-009-0200-6","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,9,9]]}}}