ROSH Gastrointestinal Practice Exam

What is the most common cause of small bowel obstruction in adults?

1. Adhesions from prior surgery

2. Colon cancer

3. Intussusception

4. Volvulus

The correct answer is: Adhesions from prior surgery

The most common cause of small bowel obstruction in adults is indeed adhesions from prior surgery. Surgical procedures in the abdomen can lead to the formation of fibrous bands of scar tissue, known as adhesions, that can cause the intestines to stick together or to the abdominal wall. These adhesions can constrict or obstruct the natural passage of intestinal contents, leading to a blockage. Adhesions account for a significant majority of cases of small bowel obstruction in adults, particularly in populations that have undergone previous abdominal surgeries, which is quite common. Understanding the patient's surgical history is critical in diagnosing the cause of their obstruction. Other potential causes, such as colon cancer, intussusception, and volvulus, are less frequent in adults compared to adhesions. While these conditions can certainly lead to small bowel obstruction, they do not occur as frequently as complications arising from adhesions in the context of adult patients.