Non-Surgical Management of Small Bowel Obstruction from Adhesions in a 92-Year-Old: A Case of Conservative Treatment in an Elderly Postoperative Patient

Small bowel obstruction (SBO) is a common and potentially severe complication, especially in elderly patients with a history of abdominal surgeries. Adhesions, a leading cause of SBO, often result from prior surgical interventions and present diagnostic and therapeutic challenges. This case report describes a 92- year-old female with a history of hysterectomy and cholecystectomy who presented with nausea, vomiting, and diffuse abdominal pain consistent with SBO. Physical examination revealed abdominal tenderness without peritoneal signs, and imaging confirmed distal SBO due to adhesions without evidence of ischemia or perforation. Conservative management, including bowel rest, intravenous fluids, antiemetics, and analgesics, led to symptom resolution within 48 hours, avoiding surgical intervention. The patient was discharged with dietary modifications and follow-up instructions to minimize recurrence risk. This case underscores the importance of considering adhesions as an etiology of SBO in elderly postoperative patients and highlights the efficacy of conservative treatment in uncomplicated cases. Early recognition, timely imaging, and a multidisciplinary approach are critical to optimizing outcomes in this vulnerable population. This report adds to the growing literature advocating for non-operative management in select cases of adhesive SBO, especially in patients with advanced age or significant comorbidities.