This is an analysis of 194 cases of small bowel obstruction that were managed at the department of general surgery, Adventist Hospital in Pusan, during 5 years from June, 1989 to May, 1994.
1) The main causes of intestinal obstruction were postoperative adhesion(43.2%), intussusception(37.6%), incarcerated hernia(11.3%), and neoplasm(3.6%).
2) The most frequent age group was the first decade(40.2%), in the ratio of male to female was 1.5:1.
3) The most common symptoms and physical findings were abdominal pain(85.5%), abdominal tenderness(74.4%), hyperperistalsis(58.7%), vomiting(54.6%), irritability(38.1%), and abdominal distension(37.1%).
4) The previous operation which may have led to adhesive intestinal obstruction were appendectomy(34.5%), gastroduodenal operation(21.4%), and gynecologic operation(17.8%).
5) The time interval between the previous operation and admission for the treatment of intestinal obstruction was 1-6 months in 28 cases(33.%), 6-12 months in 19 cases(22.6%), 1-2 years in 11 cases(13.0%), 2-5 years in 17 cases(20.2%).
6) Among the 194 cases, operative treatment was performed in 131 cases(67.5%) and conservative treatment was performed in 61 cases(31.4%).
7) In 70.4% of the conservatively treated patients, symptoms were relived within 72 hours after admission. In the operative cases, 97.1% of patients were operated on within 72 hours after admission. We feel the duration of conservative treatment
should
not be prolonged more than 72 hours.
8) As for the operative procedure of 131 cases, 55 cases(41.0%) were treated by manual reduction, 41 cases(31.2%) by resection and anastomosis, 18 cases(13.7%) by adhesiolysis.
9) The incidence of postoperative complication was 14.5% and the most common complication was wound infection(63.1%). Mortality rate was 2.0%.
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