The purpose of this study is to identify the high risk population and guide to better management. We reviewed and anaylized 103 cases of the postoperative adhesive ileus, which were relieved by conservative treatment(67 cases) and by another
laparotomy(36 cases) between the period of Jan. 1990 to Dec. 1994. We excluded adhesive ileus caused by recurrence of the malignancy.
@ES We obtained follows:
@EN 1) The most prevalent age group were in their forties(29.1%) and male to female ratio was 1.2:1.
2) The operation rate was higher in the age group of patients under 20 years old(50%).
3) The highest operation rate was previous appendectomy(47%), and the lowest was previous gastroduodenal operation(14.3%).
4) The development of adhesive ileus most commonly occurred from two to six months after the previous operation(31.0%).
5) Those who had suffered peritonitis were more likely to undergo operation.
6) On basis of the initial WBC and Hct count on admission, operations were more frequently done in the patients with WBC count of more than 10,000/mm3(42.6%) and/or Hct count higher than 46%(47.0%).
7) Radiographic presentation of mechanical ileus on initial simple abdominal film led to operation(70.3%).
8) Two or more clinical findings out of five classical findings of the intestinal obstruction(abdominal pain, tenderness, fever, tachycardia and leukocytosis) had significant diagnostic value as early clinical indicators of operation.
9) The most common location of adhesive ileus was in the ileum(75.8%), and the most common operation procedure was adhesiolysis and bandlysis.
10) The most common surgical complication was wound infection.
Non-surgical correction should be considered before deciding immediate operation, but early operation is indicated among patients with progressive bowel obstruction and strangulated obstruction.
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