A Clinical analysis of Intestinal Obstruction in the Adult.
- Author:
Hee Young YANG
1
;
Kyung Suk SUH
;
Yeo Kyu YOUN
;
Sun Whe KIM
;
Sang Joon KIM
;
Kuhn Uk LEE
;
Yong Hyun PARK
Author Information
1. Department of Surgery, College of Medicine, Seoul National Unviersity, Korea.
- Publication Type:Original Article
- Keywords:
Intestine Obstruction
- MeSH:
Adult*;
Bezoars;
Colostomy;
Diagnosis;
Female;
Fever;
Hernia;
Humans;
Intestinal Obstruction*;
Intestinal Volvulus;
Intussusception;
Leukocytosis;
Male;
Mortality;
Seoul;
Sepsis;
Surgical Procedures, Operative;
Tachycardia;
Tuberculosis;
Wound Infection
- From:Journal of the Korean Surgical Society
1997;52(3):335-342
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
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 2.1:1. 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/mm3 have the clinical significance in the strangulated obstruction. Operations were done in 196 cases and 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 others (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%).
