Three hundred nine adult patients with the diagnosis of intestinal obstruction were treated at the Department of Surgery, Seoul National University Hospital during 5 years and three months from September 1989 to December 1994. A clinical analysis
of
those patients was done and the following results were obtained. The most prevalent age group was sixth decade in cases of 90(29%) and male to female ratio was 2.11:1. The etiologic factors included adhesions 206(66.7%), malignant disease
51(16.5%),
hernia 10(3.2%), intussusception 9(2.9%), ischemic injury 7(2.3%), bezoar 6(1.9%), volvulus 6(1.9%), inflammatory disease 5(1.6%), intestinal tuberculosis 5(1.6%), and others 3(0.9%). Malignant obstructions increased and it may be caused by
increased
cases of cancer operation. The location of intestinal obstruction was small bowel in cases of 275(89%) and large bowel in the remained proportion. The frequency of strangulation was 14.2% and its causes were adhesion(56.8%), ischemic
injury(15.9%),
hernia(9.1%), malignant disease(6.8%), volvulus(6.8%), intestinal tuberculosis(2.3%), and intususception(2.3%). The main cardinal symptoms on admission were abdominal pain(93.9%), vomiting(79.3%), abdominal distension(72.8%), diarrhea(24.9%),
obstipation(17.2%), bloody stool(11.7%) and the physical signs were abdominal tenderness(74.8%), abdominal distension(72.8%), altered bowel sound(55.0%), tachycardia(18.1%), fever(17.5%), rebound tenderness(8.4%). Toxic signs such as fever,
tachycardia,
rebound tenderness with leukocytosis over 10,000/㎣have the clinical significance in the strangulated obstruction.
Operations were done in 196 cases the types of operative procedures were resection(23.7%), bypass surgery(11.4%), adhesiolysis(11.1%), colostomy(8.4%), herniorrhaphy(1.8%), bezoar removal(1.8%), and other(0.6%). Operative complications occurred
in
44
cases(22.4%) and among them, wound infection was the most common cause(7.7%). The overall mortality was 3.2% and sepsis was the most common cause(30%).
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