ABSTRACT
Over the period 1963 to July 30, 1978 a total of 312 patients with clinical picture of acute or subacute mechanical ileus were admitted to the surgical department of the district hospital in Targovishte, and 227 of them were operated on as emergency cases. During the first period covering 1963-1970, the number of operated patients amounted to 78 of which eighteen - a 23.07 per cent lethality. During the second out of 149 patients operated on twenty-three died which makes a 15.63 per cent lethality. A detailed analysis is made of the factors influencing the treatment results, and the conclusion is reached that the age of patients, cause of obstruction and level of ileus have an essential practical bearing. It is assumed that in small intestinal ileus the 11.95 per cent lethality recorded among the 92 operated patients, against 26.3 per cent in the first period, is due first and foremost to the radical operative interventions applied, aimed not only to tackle the ileus problem but also to remove the prime cause of ileus, as well as to the measures undertaken - mesenteriplication after Childs-Philips and its modification - to prevent early and late recurrence of the ileus. The tactics adopted in the various forms of small intestinal ileus are analyzed in detail. The operative methods used and lethality recorded in colonic ileus are also analyzed. Here the condition presents volvulus of the sigma and carcinoma of the colon. The immediate results of the applied radical and palliative operations are evaluated. Radical surgery of the right half of the colon is more justified. Ileus of the left half of the colon demands meticulous assessment of the local status prior to take the decision about undertaking radical intervention on passage indications. The indications for resection of the colon and its completion with anastomosis or provisory preternatural anus are discussed. The lethality rate recorded in 57 patients operated for colonic ileus during the second period amounts to 21 per cent.
