A Clinical analysis was made on 116 cases of intestinal obstruction, who admitted to the department of surgery of Capital Armed Forces General Hospital from July, 1989 to June, 1993.
1) The common causes leading to intestinal obstruction were postoperative adhesion (57.3%), Neoplasm (10.3%), recal impaction (8.6%) and inflammatory bowel disease (6.9%) in orders.
2) The previous operativons leading to adhesive intestinal obstruction were appendectomy (56.7%), gastroduodenal operation (13.4%), operation for multiple intra-abdominal organ injury (10.4%) and colon operation (6.0%) in orders.
3) The time interval between the previous operation and admission for the treatment of in testinal obstruction was 1~6 months in 16 cases (23.9%), 1~2 years in 154 cases (20.9%), 6~12 months in 11 cases (16.4%) and under 1 months in 8 cases
(11.9%).
4) The common symptoms and physical findings were abdominal pain (88.8%), abdominal tenderness (79.3%), vomiting (51.7%), abdominal distention (50.9%) and hyperperistalsis (48.3%), in orders.
5) Among 116 cases, the conservative treatment was performed in 33 cases (28.4%) and operative management was performed in 83 cases (71.6%)
6) In operative cases, there were leukocytosis in 68.7%, peritoneal irritation sign in 44.6%, fever in 36.1% and tachycardia in 22.8%, In conservative cases, here were leukocytosis in 66.7%, peritoneal irritation sign in 48.5%, fever in 33.3%
and
tachycardia in 24.3%. Thus, above ciassical 4 signs played no significant role on differentiation between operative and conservative treatment.
7) In 60.6% of conservatively treated patients, symptoms were relieved within 72 hours after admission. In operative cases, 69.9% of patients were operatied within 72 hours after admission. So the duration of the conservative treatment should
not
be
prolonged more than 72 hours.
8) The common types of operative procedure were adhesiolysis (44.6%), small bowel resection (22.9%), colon resection (9.6%) and removal of bezoar (6.0%).
9) The incidence of post-operative complications was 15.7% and the most common complication was wound infection (46.2%).
10) We suggest that the mainstay of treatment should be early operative management within 72 hours if there is no improvement by conservative management.
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