This clinical observation was made on 80 cases of postoperative adhesive intestinal obstruction, who admitted to department of surgery, Tae Jon Eul Ji General Hospital from january, 1989 to December, 1994.
@ES The results of the study were obtained as follows;
@EN 1) The frequent age group was from 41 to 60 years in 34 cases(42.6%). Male to female ratio was 2.3:1
2) Previous abdominal operation leading to adhesive ileus revealed Appendectomy(27.5%), Gastroduodenal operation(18.8%), Small bowel operation(16.3%), and Gynecologic operation(10.0%).
3) Previous operation according to degree of contamination were clean contaminated in 34 cases(42.5%), contaminated in 29 cases(36.3%), clean in 10 cases(12.5%), and dirty in 7 cases(8.7%).
4) The interval between previous operation and obstruction were 31 cases(38.7%) within a year, and 14 cases(17.5%) above ten years.
5) The interval between admision and operation were 24 cases(30.0%) within 1 days (emergency operation), and 14 cases(17.5%) above 7 days.
6) The cardmal symptoms and signs were abdominal pain (82.9%), abdominal tenderness(84.3%), altered bowel sound(64.3%), and vomiting(58.6%).
Leukocytosis(1000/mm3) was 39 cases(48.7%).
7) The positive finding of X-ray studies was 63 cases(78.8%).
8) The incidence of bowel strangulation was 10 cases(12.5%).
9) The variable patterns of adhesion and obstruction were angulation by adhesion to previous incisional wound o peritoneum in 42 cases(52.5%), angulation by interloopal or mesenteric adhesion in 37 cases(46.3%), and adhesive band constriction or
contraction in 20 cases(25.0%).
10) The incidence of postoperative complications was 13 cases(16.3%), and most common complication was wound infection in 4 cases(30.8%).
11) The over all mortality rate was 4 cases(5.0%), and most common cause of death was sepsis in 2 cases(50%).
In conclusion, early diagnosis, and adequate preoperative management and surgical intervention reduce the postoperative complications and mortality rate.
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