Comparison of Outcomes of Management of Bowel Obstruction
University of Washington
550 participants
Feb 1, 2026
INTERVENTIONAL
Conditions
Summary
The Comparison of Outcomes of Management of Bowel Obstruction (COMBO) trial is a patient-level randomized trial of a short course of dexamethasone + supportive care vs supportive care alone for patients with adhesion-related small bowel obstruction (aSBO). The goal of the COMBO trial is to answer the question: Can Dexamethasone increases the proportion of patients with resolution of aSBO with non-operative management (without complication) based on an established minimal important clinical difference.
Eligibility
Inclusion Criteria7
- Adults ≥18 years of age recruited from UWMC
- Patients presenting to surgical services through the Emergency Department, diagnosis of SBO, consulted by surgeon, and an urgent or emergency operation is deemed not necessary by surgeon.
- Diagnosis of aSBO is established by;
- CT findings consistent with diagnosis of SBO; and
- signs and symptoms consistent with SBO; and
- Adhesions from prior abdominopelvic surgery are the likely cause of SBO (absence of incarcerated hernia, internal hernia, masses, fistula, stricture, volvulus, acute episode of inflammatory bowel disease (IBD) flare, etc.).
- Ability to provide written or electronic informed consent in English and answer teach-back questions
Exclusion Criteria7
- Signs and symptoms of peritonitis with emergency operation planned
- Planned urgent operation within the next 12 hours
- Allergy to dexamethasone
- Surgery within prior 6 weeks
- Unable or unwilling to return or be contacted for and/or complete research surveys
- Currently incarcerated in a detention facility or in police custody (patients wearing a monitoring device can be enrolled) at baseline/screening
- Individuals with latent infections who have an increased risk of infection.
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Interventions
\*Please see description for dexamethasone + supportive care arm.
\*Please see description for supportive care arm.
Locations(3)
View Full Details on ClinicalTrials.gov
For the most up-to-date information, visit the official listing.
NCT07084441