Clinical Study on the Postoperative Adhesive Smal Bowel Obstruction

ABSTRACT

This clinical report is a review of the medical records of the 161 cases of postoperative adhesive intestinal obstruction treated at the Department of Surgery, Chung-Goo Sungsim General Hospital during 5 years from January 1991 to December 1995. The results of the study are as follows; 1) The most frequent age group was the 4th decade and the most prevalent age groups in the strangulated intestinal obstruction were below 10 years and above 60 years. 2) There was no difference among the types of previous abdominal operations in terms of the possibility of the strangulation. 3) The incidence of postoperative complication in the strangulated intestinal obstruction(58.3%) was higher than that in the non-strangulated intestinal obstruction(7.7%). 4) The overall mortality rate was 2.5%. The mortality rate in the strangulated intestinal obstruction was 8.3%, and was higher than that in the non-strangulated intestinal obstruction. 5) It is ideal to operate just before progression to strangulation, but it is not easy to decide when it happens. An operation should be considered in the following cases. (1) The presence of two or more symptoms; abdominal pain, obstipation, vomiting and abdominal distension. (2) The presence of two or more signs; leukocytosis, fever, tachycardia, localized abdominal tenderness, rebound tenderness and continuous abdominal pain. (3) Clinical signs of deterioration after 72 hours of conservative treatment.