Background: Acute intestinal obstruction (AIO) in elderly and senile patients presents distinct challenges due to concurrent pathologies and altered clotting mechanisms, leading to increased postoperative complications and mortality. Purpose: This study aims to develop predictive and preventive methods for postoperative complications of AIO in elderly and senile patients. Methods: Pathogenetic mechanisms underlying AIO manifestations, such as Intraperitoneal hypertension and Intraenteric hypertension, were analyzed for their clinical and laboratory correlations. Retrospective analysis of postoperative courses in 53 patients categorized into survivors and deceased subgroups was conducted. Conclusion: The use of the therapeutic and diagnostic algorithm developed by us, based on the prediction and prevention of postoperative complications of acute intestinal obstruction in elderly and senile patients, has significantly reduced the cases of deaths, especially from various pathologies associated with increased thrombosis and, first of all, from pulmonary embolism.