Intestinal obstruction from adhesions--how big is the problem?

Area of Science:

• Abdominal Surgery
• Gastroenterology
• Surgical Complications

Background:

• Adhesions following laparotomy are not well-documented.
• Previous surgery significantly increases the risk of intra-abdominal adhesions.

Purpose of the Study:

• To investigate the incidence of intra-abdominal adhesions after laparotomy.
• To determine the rate of intestinal obstruction caused by postoperative adhesions.

Main Methods:

• Prospective analysis of 210 patients undergoing laparotomy with prior abdominal surgery.
• Review of 28,297 adult general surgical admissions over 25 years for adhesive obstruction.
• Follow-up of 2708 laparotomies for up to 91 months to assess for obstruction.

Main Results:

• 93% of patients with prior abdominal operations had adhesions, compared to 10.4% of first-time laparotomies.
• Adhesive intestinal obstruction accounted for 0.9% of general surgical admissions and 3.3% of laparotomies.
• 1% of laparotomies resulted in intestinal obstruction due to adhesions within one year, with 0.5% occurring within one month.

Conclusions:

• Intra-abdominal adhesions are a frequent consequence of previous abdominal surgery.
• Postoperative adhesions represent a significant cause of intestinal obstruction, with a high incidence of early onset.
• Lower abdominal surgeries, especially those involving the colon, are frequently associated with adhesive obstruction.