The materials in this report were based on 140 cases of intestinal obstruction caused by postoperative
adhesions which were treated in this surgical department at the Presbyterian Hospital during 12 years
and 6 months from October 1, 1958 to March 31, 1971.
1) The majority of the patients ranged 30 to 39 yeard of age was 39 cases(27.9%). The sex ratio
two for men to one for women.
2) The cardinal symptoms and signs were very similar to usual intestinal Obstruction except past
history of abdominal surgery. They were abdominal pain in 77%(18 cases), vomiting in 58%(81 cases),
and abdominal distension in 28% (39 cases).
3) The laboratory data were as followings: leukocytosis in 32% (45 cases)m leukocytes within nor
mal limit in 45% (64 cases), increased segmented neutrophils in 53% (74 cases), hematocrit within
normal limit in 45% (63 cases), increased urine specific gravity (over 1,021) in 35% (49 cases). All
of above date were within normal limits except neutrophil count and specific gravity of urine.
4) The diagnosis of intestinal obstruction caused by postoperative adhesions was relatively easy by
previous history of abdominal surgery, cardinal symptoms and signs of intestinal obstruction, and simple
abdominal X-ray films.
5) Incidence of previous operations was classified as followings frequency in order: appendectomy in
34.3% (48 cases). gynecological operations in 19.2% (27 cases), surgery of small intestine in 18.7% (26
cases). Most of gynecological operations were hysterectomies which cuonted 8.6% (12 cases).
6) Duration from previous operations to these illness were various. These illness developed within
30 days were 29cases (20%) and over 30 days were 111 cases (80%). The longest duration was over
30 years after appendectomy.
7) As for the methods of treatment : 34 cases (24.2%) were treated by intubation of Miller
Abbot tube, 50 cases (35.8%) by lysis of adhesions. All cases using Mille Abbott tube were 68 cases
(49.3%), and none of them was recurrent intestinal obstruction caused by readhesions. Recurrent 12
casess of surgical patients didn´t use the Miller0Abbott tube, The majority of postoperative complications
was wound infection in 12% (17 cases), and most of causative organisms were bacilli in 9.2%
(Escherichia coli in 5%).
9) The mortality was 7.1% (10 cases). Most of them were in over 60 years of age.
10) The incidence of intestinal obstruction caused by postoperative adhesions was 34.3% (140 cases
of 408 cases of intestinal obstruction).
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