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Introduction <p>Small Bowel Obstruction (SBO) is a common yet serious surgical emergency. Prompt diagnosis and timely surgical intervention are critical to patient outcomes. However, clinical decisions may be delayed by interdepartmental disagreements or ethical ambiguities. This case highlights the impact of such delays and the importance of effective interdisciplinary communication in emergency care settings.</p> Case Presentation <p>A 60-year-old woman with a recent history of hysterectomy presented with abdominal pain, food intolerance, and constipation. Despite radiological and laboratory evidence indicating SBO, the patient’s transfer for surgery was delayed due to disagreement between the surgical and obstetrics-gynecology teams. The situation escalated, prompting a forensic consultation. Only after a significant clinical decline did the patient undergo laparotomy, which confirmed adhesive small bowel obstruction. Postoperative recovery was uneventful. Ethical challenges included informed consent, patient autonomy, and departmental accountability.</p> Conclusions <p>This case underscores the need for timely, ethically grounded decision-making and interprofessional coordination in emergency scenarios. Delays in care due to systemic or hierarchical barriers can result in preventable harm. Adoption of standardized communication tools such as TEAMSTEPPS and adherence to ethical frameworks emphasizing beneficence and non-maleficence are crucial. Surgeons and emergency teams must prioritize patient-centered care and be empowered to act decisively when clinical urgency outweighs bureaucratic hesitations.</p>

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Enhancing Patient Management through Effective Communication and Ethical Decision-Making: A Case Report on Small Bowel Obstruction

  • 期刊论文

  • 发表日期：

    2026年4月1日

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  • Atefeh Kashanizadeh,
  • Aidin Shahrezaei,
  • Saeed Biroudian,
  • Mina Forouzandeh,
  • Maryam Sohani,
  • Ali Safaei Ghaderi,
  • Seyed Yahya Zarghami

摘要

Introduction

Small Bowel Obstruction (SBO) is a common yet serious surgical emergency. Prompt diagnosis and timely surgical intervention are critical to patient outcomes. However, clinical decisions may be delayed by interdepartmental disagreements or ethical ambiguities. This case highlights the impact of such delays and the importance of effective interdisciplinary communication in emergency care settings.

Case Presentation

A 60-year-old woman with a recent history of hysterectomy presented with abdominal pain, food intolerance, and constipation. Despite radiological and laboratory evidence indicating SBO, the patient’s transfer for surgery was delayed due to disagreement between the surgical and obstetrics-gynecology teams. The situation escalated, prompting a forensic consultation. Only after a significant clinical decline did the patient undergo laparotomy, which confirmed adhesive small bowel obstruction. Postoperative recovery was uneventful. Ethical challenges included informed consent, patient autonomy, and departmental accountability.

Conclusions

This case underscores the need for timely, ethically grounded decision-making and interprofessional coordination in emergency scenarios. Delays in care due to systemic or hierarchical barriers can result in preventable harm. Adoption of standardized communication tools such as TEAMSTEPPS and adherence to ethical frameworks emphasizing beneficence and non-maleficence are crucial. Surgeons and emergency teams must prioritize patient-centered care and be empowered to act decisively when clinical urgency outweighs bureaucratic hesitations.