Join Drs. Georgoff, Burke, and Premkumar in this episode of EPA Playbook, where we tackle the evaluation and management of small bowel obstruction. Through a realistic series of scenarios, we walk step-by-step through how junior residents can approach this diagnosis using an evidence-based approach.

We break down the key components of the small bowel obstruction EPA, from rapid initial assessment and focused physical exam to early resuscitation, recognizing when to go straight to the OR, and post-operative care. Along the way, we highlight critical teaching points you’ll actually use on call. Whether you’re a new intern or an early resident looking to build confidence, this episode is designed to help you act decisively and move one step closer to entrustment.

***FREE EPA COURSE: https://behindtheknife.org/premium/epa-playbook
Simply create an account on behindtheknife.org or our app and you the course will automatically show up in your Library.

For additional information on EPAs, visit the American Board of Surgery EPA webpage: https://www.absurgery.org/get-certified/epas/.

BTK Resources:

Nasogastric Tube (NGT) Management Video
https://behindtheknife.org/video/behind-the-knife-nasogastric-tube-ngt-management

Nasogastric Tube (NGT) Placement Video
https://behindtheknife.org/video/behind-the-knife-nasogastric-tube-ngt-placement

Ostomy Marking Video
https://behindtheknife.org/video/behind-the-knife-ostomy-marking

How to Change an Ostomy Appliance Video
https://behindtheknife.org/video/behind-the-knife-how-to-change-an-ostomy-appliance

How to Manage a Challenging Ostomy Video
https://behindtheknife.org/video/behind-the-knife-how-to-manage-a-challenging-ostomy

Cited Studies:

National prospective cohort study of the burden of acute small bowel obstruction https://doi.org/10.1002/bjs5.50136
Management and short-term outcomes of patients with small bowel obstruction in Denmark: a multicentre prospective cohort study https://doi.org/10.1007/s00068-022-02171-y
Multi-institutional, prospective, observational study comparing the Gastrografin challenge versus standard treatment in adhesive small bowel obstruction https://doi.org/10.1097/ta.0000000000001499
Evaluation and management of small-bowel obstruction: an Eastern Association for the Surgery of Trauma practice management guideline https://doi.org/10.1097/ta.0b013e31827019de