CLINICAL CHARACTERISTICS OF SMALL BOWEL OBSTRUCTION WITHOUT A HISTORY OF ABDOMINAL SURGERY

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  • TAKAHASHI Nobuyasu
    Department of Surgery, Miyazaki Medical Association Hospital Department of Surgery 1, Miyazaki University School of Medicine
  • SHIMAYAMA Toshio
    Department of Surgery, Miyazaki Medical Association Hospital
  • KAWANO Kikuo
    Department of Surgery, Miyazaki Medical Association Hospital
  • HIYOSHI Masahide
    Department of Surgery, Miyazaki Medical Association Hospital Department of Surgery 1, Miyazaki University School of Medicine
  • NAGANO Motoaki
    Department of Surgery, Miyazaki Medical Association Hospital Department of Surgery 1, Miyazaki University School of Medicine
  • CHIJIIWA Kazuo
    Department of Surgery 1, Miyazaki University School of Medicine

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  • 開腹既往歴のない小腸イレウス症例の検討

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Determining the cause of small bowel obstruction in patients who have not undergone abdominal surgery is difficult and can result in a delay of treatment. Out of 295 consecutive patients with small bowel obstruction treated surgically at our hospital during a 7-year period 1998-2004, 36 had neither a palpable strangulated hernia nor a history of laparotomy. We investigated the timing of surgery and necessity of bowel resection in these 36 patients. Small bowel obstruction was caused by adhesive bands in 12 patients, obturator hernia in 10, internal hernia in 5, food-induced obstruction in 4, intussusception in 4, and volvulus in 1, and all except the food-induced obstruction were precisely diagnosed by means of computed tomography. Fourteen of the 36 patients required intestinal resection. Significant differences observed between the 14 patients who required resection and the remaining 22 who did not were in the duration of symptoms before surgery and surgical treatment within 24 hours after admission. These findings suggest that computed tomography diagnosis and surgical intervention within 24 hours after admission can prevent unnecessary resection in patients with small bowel obstruction and no prior laparotomy.

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