[Mechanical ileus: analysis following 360 operations]

360 laparotomies in mechanical bowel obstruction were performed in a five year period at the Department of Surgery of the University Hospital, Basel. The overall mortality rate was 50/360 = 14%. The most frequent cause of death was cardio-respiratory insufficiency (19/50 = 38%) and postoperative peritonitis (15/50 = 30%). The most common etiology of bowel obstruction and the corresponding mortality rate was adhesion (151/360 = 42%; mortality 8.5%), large bowel cancer 83/360 = 23%; mortality 13.0%) and incarcerated hernia (57/360 = 16%; mortality 10.5%). The interval between onset of symptoms and hospitalization and between hospitalization and operation in the nonfatal group was 19 days and 28 hours respectively, and in the fatal group 26 days and 21 hours respectively. In conclusion, early surgical intervention in bowel obstruction and a meticulous technique for anastomosis when bowel resection is necessary are the most important factors in improving the results.