Use of Nasogastric Tubes in Adult Patients with Small Bowel Obstruction

INTERVENTION: No nasogastric tube, in addition to standard care which may include intravenous fluids, analgesia, anti‐emetics, and/or surgery as determined by surgeon in charge based on progress of signs and symptoms of bowel onstruction including radiological changes. Adherence to ransomisation will be recorded from the medical record. CONDITION: Oral and Gastrointestinal ‐ Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon small bowel obstruction;intestinal obstruction; ; small bowel obstruction ; intestinal obstruction PRIMARY OUTCOME: Rate of operation[Day 30 after admission as assessed by review of medical record.] SECONDARY OUTCOME: Incidence of NG tube complications up to time of removal as recorded in the medical record including but not limited to, displacement, pressure areas on nares, gastric erosion.[ Up to day 90 post discharge..] Incidence of post‐operative pulmonary complications as graded by the Melbourne Group Scale using the medical record. These may inlcude chest x‐ray report of collapse/consolidation, production of yellow or green sputum different to preoperative assessment, presciption of antibiotic for a respiratory infection. ; [By Day 30 post discharge.] Incidence of surgical complications (Clavien‐Dindo classification) by review of the medical record and self‐reported by participant via phone follow‐up. Complications may include but not limited to deep vein thrombosis, pulmoney embolus, surgical site infection, aspiration pneumonia.[Identified by day 30 post discharge by review of the medical record and self‐reported by the patient at day 30 follow‐up post discharge] Mean length of hospital stay (LOS) assessed at day 90. [By review of the medical record at day 90 post discharge.] Mean LOS for patients admitted to ICU as assessed by review of the medical record.[ By day 90 post discharge.] Mean time to operation as assessed by review of the medical record.[By day 30 post discharge..] Quality of Life patient reported outcome using the EQ‐5D‐5L..[Measured at admission within 24 hours and at days 30 and 90 post discharge.] Rate of admission to intensive care as assessed by review of the medical record. [By day 90 post discharge.] Rate of return to the operating theatre after initial operative procedure as assessed by review of the medical record by day 30.[By day 30 post dishcarge.] Rate of use of gastrograffin[Assessed by review of the medication record after hospital discharge.] Rate of use of low continuous suction applied to nasogastric tube.[Assessed by review of medical record after hospital discharge] INCLUSION CRITERIA: • Patients 18 years and over. • Past history of abdominal surgery. • Radiological evidence of small bowel obstruction. • Direct presentation to the hospital from home or usual place for residence.