Mechanical small bowel obstruction

Abstract

1. 1. A review of one hundred seventy patients with mechanical small bowel obstruction operated on at St. Luke's Hospital from January 1952 through December 1959 is presented. 2. 2. Sixty-six per cent of the patients had obstruction caused by adhesions and 14.7 per cent had mechanical obstruction due to hernias. Adhesions, previously a minor cause of small bowel obstruction, are now the most frequent etiologic agent. Hernias, previously the most frequent, are now a minor cause. 3. 3. The operative mortality in this series of acute mechanical small bowel obstruction was 15.3 per cent. The patients with incarcerated hernias containing small bowel, in whom the obstruction played an insignificant role, have been deleted from this study. Had they been included, the mortality rate would have been significantly lower. 4. 4. A further reduction in mortality may be realized by vigorously attacking the respiratory problem, and by instituting antibiotic therapy at the earliest possible time in the course of strangulation obstruction. 5. 5. The incidence of intestinal obstruction, and therefore the number of deaths due to obstruction, in all probability can be reduced by further improvement in operative technic and pre- and postoperative care.