Peritoneal adhesions as a cause of mechanical small bowel obstruction based on own experience

Bowel obstruction is a condition which has been known for many years. As time goes by, the problem is still often encountered at surgical emergency rooms. More than 20% of emergency surgical interventions are performed because of symptoms of digestive tract obstruction with the disease mostly situated in the small bowel. Rates of causative factors of the disease have changed over recent years and there have been increasingly more cases of small bowel obstruction caused by peritoneal adhesions, i.e., adhesive small bowel obstruction (ASBO). The aim of the study to analyse the reasons and incidence of adhesive small bowel obstruction during two periods of time (1990-1995 and 2005-2010).

We performed a retrospective analysis of medical records of patients hospitalized at the 1st Department of General Surgery and Surgical Oncology of the Provincial Polyclinic Hospital in Płock between 1990 and 1995. The outcomes were compared with another period of 2005-2010.

We found that the incidence of adhesive small bowel obstruction increased from 58 cases in the first period to 215 cases in the second one, and the outcomes improved. The proportion of patients who underwent surgery diminished from 38% to 13%. The mean hospitalization time shortened and was 11.3 days and 6.95 days during 1990-1995 and 2005-2010 periods of time, respectively. In the first group, patients who had a surgery were hospitalized for 17.8 days and those who were treated conservatively for 8.08 days. In the second group, the mean hospital stay decreased to 15.6 days and 5.7 days in the case of surgical and conservative treatment, respectively. The age of onset declined from 56.63 years in the first period to 52.54 years in the other one.

Analysed data show an increasing number of patients with adhesive small bowel obstruction. The highest risk of the disease was associated with operations on the large bowel and gynaecological procedures.