[Peritoneal adhesions as cause of small bowel obstruction]

Due to increasing number of people treated surgically there is a rising a problem of peritoneal adhesions. They can cause pain, infertility of young women, technical problems during successive operations and--last but not least--adhesional bowel obstructions. Patients operated on due to mechanical small bowel obstruction in the 2nd Department of Surgery from 1st January 1987 to 30th June 2002 were included in the study. Diagnosis was set using clinical examination and imaging techniques such as X-ray and ultrasound and was confirmed during the operation. Strangulated hernia followed by peritoneal adhesions proved to be the most common causes of small bowel obstruction. Overall mortality rate in the group of adhesion-related obstructions reached 9.6%. In the group of 53 (39%) patients requiring small bowel resection mortality rate was 15.1%, and in the remaining patients, requiring only adhesiolysis--6.0%. There was markedly higher (18.4%) mortality rate noticed in the group of people older than 69 years as compared to younger patients (6.1%). More than twofold decrease in postoperative mortality rate observed throughout 15 years should be attributed to improvement of in-hospital care.