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Mechanical small bowel obstruction due to adhesions
Annales Chirurgiae Et Gynaecologiae
|January 1, 1978
Summary
Adhesive small bowel obstruction, often caused by prior surgery, affects 80 per million annually. Early intervention and considering bypass or resection for severe adhesions can improve outcomes and reduce mortality.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Adhesive small bowel obstruction (ASBO) is a significant surgical complication.
- Previous laparotomy is the primary cause of adhesions leading to ASBO.
Purpose of the Study:
- To analyze the incidence, causes, diagnosis, and outcomes of adhesive small bowel obstruction.
- To evaluate mortality rates and recurrence following surgical intervention for ASBO.
Main Methods:
- Retrospective analysis of 103 patients operated on for ASBO between 1971-1975.
- Utilized contrast medium radiological studies for diagnosis in less severe cases.
- Examined outcomes including mortality, complications, and recurrence rates.
Main Results:
- Incidence of ASBO was 80 per million inhabitants per year.
- Appendicectomy, gynecological, and intestinal operations were common preceding surgeries.
- Mortality rate was 5.8%, increasing with symptom duration; early operation (within 24 hours) halved mortality.
- Recurrence rate was 27.8%, with 8 patients requiring relaparotomy.
Conclusions:
- Adhesive small bowel obstruction poses a considerable surgical challenge with a significant recurrence rate.
- Early surgical intervention is crucial for reducing mortality.
- Bypass or bowel resection may be safer than lysis of extensive adhesions in specific cases.