The intestinal adhesion following intraperitoneal operation is the most common cause of adult intestinal obstruction in the developed countries of the world.
Many experimental and clinical work have been performed in order to prevent the postoperative adhesion and to arrive at confident preoperative diagnosis of intestinal gangren. But the results reveal no unanimous clinical beneficial outcome.
We analyzed 103 patients of postoperative adhesive intestinal obstruction who were treated during 4 years from January, 1988 to December, 1991 at the department of general surgery of Ewha Womans University. And the following results were
obtained.
1) The sex ratio was 1.78:1, male predominate over female and the most frequent age group was 4th and 6th decades.
2) The most common previous operation was Appendectomy(31%) followed by gynecological operation including hysterectomy, salphingoophorectomy(20%).
3) There was no significant difference in duration of conservative treatment between the adhesiolysis group, the bowel resection group and the conservative treatment group.
4) The operation rate in early postoperative obstruction was 39% which show no difference from the other group of 38%. But the bowel resection rate was low(14.3%) than the other group (31.3%).
5) The operation rate was high in the patients group who has long Sx duration before admission.
6) 38% of patients with intestinal strangulation show 3 or 4 positive signs of 4 classic signs (Tachycardia, Pyrexia, Leukooytosis, Localized abdominal tenderness) which was distinguished from the simple intestinal obstruction(5%). But one
patient
of
the strangulation group exibited none of the above positive signs and two patients of the strangulation group show only one positive sign.
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