Once the diagnosis of obstruction has been entertained, the clinician should decided if the patient has any evidence of a complication, from the obstruction. If there is evidence of toxicity, sepsis, tenderness or leucocytosis then urgent surgery is usually required. If not the clinician has more time to decide the best course of action.
Once again the main problem here is the patient with uncomplicated obstruction with a past history of abdominal surgery. Again, consideration should be given to a trial of Gastrografin, to clarify the situation.