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KMID : 0371319700120030011
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Journal of the Korean Surgical Society
1970 Volume.12 No. 3 p.11 ~ p.15
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Clinical Observation of Small Bowel Obstruction
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黃一愚/Whang, Il Woo
李相國/崔世永/申鉉洙/徐廷旭/徐輔祥/Lee, Sang Kook/Choi, Sae Yung/Shin, Hyun Soo/Suh, Chung Wook/Suh, Bo Sang
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Abstract
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During the years 1959 to 1969 at the Kyung Pook National Universtiy Hospital 242 patients were treated for small bowel obstruction. A clinical analysis was done and the results abtained were as follows:
1. The causes of obstruction in 216 cases proven at operation were postoperative adhesion in 101 patients(47%), intussusception in 63 patients (29%) and hernia in 19 patients (9%), These three represent 85% in this series.
2. The positive sign for the diagnosis of small bowel obstruction with X-ray studies was present in 91.7% of 155 cases.
3. While 26 patients were treated non-operatively with success, surgical correction was inevitable for 216 patients. Of these 216 cases, lysis of adhesion was done in 80 cases, manual reduction in 54 cases, bowel resection in 51 cases and other procedures in 31 cases.
4. There were 18 deaths in the series, with a mortality of 7.4%. The mortality in strangulated cases was exceendingly high (27.7%) compared to that of simple obstruction (4.4%).
5. Complications of therapy occurred in 17.7% of the patients. The most of common was infection, either of the wound, or peritonitis. There were 8 refractory shock including septic origin, of them 7 died. The incidence of cardiopulmonary complication was very low.
6. Plications were added in 16 patient in an attempt to pervent recur of obstruction, and their results were good.
7. To minimize or avert the wound infection, delayed primary closure was attempted in 15 cases with suspected contamination during operation. Their postoperative hopital stay was 12.3 days in average, 4.1 days being shortened compared to the ordinary group.
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