[Surgical therapy of ileus of the small intestine]

Small bowel obstruction is a disease the surgeon frequently is confronted with. In the present study the records of the patients (n = 202) with mechanical obstruction of the small intestine from the last four years were analysed and the results are critically compared with the literature.

In the reported retrospective study the length of patient's history, the cause of bowel obstruction, the preoperative examinations performed, the kind of surgical intervention and the postoperative management and outcome were investigated.

The average patient's age was 62 years, the mean preoperative duration of symptoms was 6.5 days. 77% of the patients had underwent abdominal surgery prior to the obstruction. Conventional x-ray was performed in 92%, gastrographin passage in 46% and CT-scan in 23% of the cases. The average length of hospitalisation was 12 days. The overall postoperative morbidity was 21%, the mortality 2.5%.

It could be shown that patient's history, clinical symptoms and conventional x-rays of the abdomen are sufficient for the indication of surgical intervention. In uncertain cases the examination of the passage with contrast medium is recommended. The surgical results of small bowel obstruction management have significantly improved over the past decades, today's mortality is lower than 5%.