[Surgical interventions in the digestive tract during gynecological and obstetric operations]

At the University Hospital Department of Gynecology and Obstetrics in Novi Sad, from 1945 to 1975, there were 17,362 major gynecological (laparotomies and vaginal) operations and cesarean sections. During these operations 0.11% of patients (19 women) had accidental injuries of the digestive organs (small or large intestines, or the mesenterium). All these injuries were treated during one and the same surgical act (sutures or resections of the small or large intestines). In 39 (0.22%) women, owing to a wrong preoperative diagnosis, laparotomy revealed inflammatory changes or tumours of the digestive tract which required primary surgical treatment: resection of the small or large intestines or the treatment of the perforated or gangrenous appendix, etc. Among the operations performed there were also 944 appendectomies and 65 hernitomies (in the course of gynecological operations or, less frequently, as separate interventions), 13 intestinal injuries during legal and illegal abortions, as well as 9 other surgical interventions (splenectomies, surgical treatment of the ileus, etc). In a total of 1079 pelvic operations also operations of the digestive tract were jointly made, which makes 6.46% of all major gynecological operations and cesarean sections. Obviously, it is not rare that the gynecologist-obstetrician faces situations requiring surgical interventions in the abdominal organs along with those in the genital tract. This raises the question of how much the gynecologist-obstetrician should be qualified also for abdominal surgery and urology, which is particularly important from the point of view of postgraduate education of gynecologists-obstetricians. In this country there are still certain dilemmas concerning this question.