[ACUTE SMALL BOWEL OBSTRUCTION. SOME ASPECTS OF CONSERVATIVE TREATMENT].

One of the complex problems in urgent abdominal surgery is acute small bowel obstruction (ASBO). The goal of our research is to improve treatment results for patients with ASBO by optimizing their diagnostic and therapeutic algorithm taking into account changes in the small intestine during its obstruction. We made a complex examination of 56 patients with ASBO who recovered after conservative therapy. Besides common tests, we also checked the severity of intoxication syndrome using the leukocyte intoxication index, middle mass molecules concentration, erythrocyte sorption capacity, comorbidity index, patients' nonspecific resistance, autonomic nervous system, and results of abdominal radiographic and sonographic studies. There were 45 (80,36%) of patients below 60 years of age; 55 patients were from 60 to 75 years of age - (19,65%). 39 (69.64%) patients were hospitalized on the first day of the disease. 22 (39.29%) were admitted during the first phase of ASBO, the rest - in the second. 53 (94.64%) of cases were functionally compensated. Sympathetic nervous system predominance was observed in 31 (55.56%) of cases. The comorbidity index was 0.8 at the age below 60, while it was increased by 5.45 times at the age 60-74 and by 6.25 times at the age of 75, respectively. We draw attention to the frequency of clinical, X-ray and sonographic signs of ASBO in these patients. We outlined prognostic criteria that can adequately reflect clinical course of ASBO in unoperated patients and effectiveness of conservative therapy. Depending on the state of the gastrointestinal tract at admission, a differentiated conservative therapy was performed aimed at restoring and normalizing motor activities of the digestive tract. We offered an algorithm for treatment patients with ASBO.