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Patients were followed to last note in medical records or death.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Result<\/jats:title>\n<jats:p>The cause of obstruction was a fibrous band in 56% and diffuse adhesions in 44%. Early overall postoperative morbidity was 48 and 10% required a re-operation. Complications, intensive care and early mortality (<jats:italic>n<\/jats:italic>\u00a0=\u200921, 5.2%) were related to age (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.05) and American Society of Anesthesiologist\u2019s class (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.01). At a median follow-up of 66\u2009months (0\u2013122), 72 patients (18%) had been re-admitted because of SBO; 26 of them underwent a re-operation. Previous laparotomies (<jats:italic>p<\/jats:italic>\u00a0=\u20090.013), diffuse adhesions (<jats:italic>p<\/jats:italic>\u00a0=\u20090.050), and difficult surgery (bowel injury, operation time and bleeding, <jats:italic>p<\/jats:italic>\u00a0=\u20090.034\u20130.003) related to recurrent SBO. The cohort spent 6735\u2009days in hospital due to SBO; 772 of these days were due to recurrent SBO. In all, 61% of the cohort was alive at last follow-up. Late mortality was related to malignancies, cardiovascular disease, and other chronic diseases.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>About half of patients with SBO are elderly with co-morbidities which predispose to postoperative complications and mortality. Diffuse adhesions, which make surgery difficult, were common and related to future SBO. Overall, nearly one-fifth of patients needed re-admission for recurrent SBO. Continued research for preventing SBO is desirable.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Trial registration<\/jats:title>\n<jats:p>The study was registered at <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> (NCT03534596, retrospectively registered, 2018-05-24).<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12893-020-00724-9","type":"journal-article","created":{"date-parts":[[2020,4,6]],"date-time":"2020-04-06T15:04:22Z","timestamp":1586185462000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Mechanisms of adhesive small bowel obstruction and outcome of surgery; a population-based study"],"prefix":"10.1186","volume":"20","author":[{"given":"Thorbj\u00f6rn","family":"Sakari","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malin","family":"Christersson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urban","family":"Karlbom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,4,6]]},"reference":[{"issue":"9163","key":"724_CR1","doi-asserted-by":"publisher","first-page":"1476","DOI":"10.1016\/S0140-6736(98)09337-4","volume":"353","author":"H Ellis","year":"1999","unstructured":"Ellis H, Moran BJ, Thompson JN, Parker MC, Wilson MS, Menzies D, et al. 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The study was approved by the local ethical committee at Uppsala University (Dnr 2015\/196) and registered at  (NCT03534596, retrospectively registered 2018-05-24).Informed consent was not obtained from individual participants included in the study. The study was approved by the local ethical committee at Uppsala University, informed consent was not needed. The study was retrospective and contained no sensitive data and no data at the individual level.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors (TS, MC and UK) declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"62"}}