Abstract

ADHESION BAND IN EMERGENCY OPERATION AND INTESTINAL OBSTRUCTION

Esmaeil Hajinasrollah MD*, Bahador Oshidari MD, Amir Zamani MD, Hadi Mirhashemi MD, Fariborz Rashno MD, Mohsen Suri MD and Hassan Peyvandi MD

Abstract

Background: To investigate the epidemiologic features, clinical characteristics and outcomes of patients with intestinal obstruction in an academic tertiary referral center. Methods: Clinical records of 241 patients with intestinal obstruction were retrospectively reviewd. The patients referred to an academic tertiary center between 2009 to 2019. The patients with the final diagnosis of intestinal obstruction who underwent operation were entered into the study. Exclusion criteria consisted of the incomplete records of the patients, congenital adhesion band and conservative managements. Demographic data, etiology of obstruction, management type and final outcome of the patients were extracted from the files. Results: Average age of the patients were 56.4 ± 21 years. One-hundred and seventy two (71.4 %) patients were male. Adhesion band was the first etiology of small intestinal obstruction in 73 (47%) patients followed by abdominal hernia in small intestine in 15 (10%) patients and tumors in large intestine in 13 (15%) of patints. In adhesion band group, there were 58 males, with an average of 31 years, ranging in age from 4 years to 80 years. Appandectomy was the most common surgical procedure in 37 (51%) patients followed by trauma surgery in 18 (25%) patients. Twelve patients (16%) had history of more than one abdominal operation. Conclusions: Adhesion band is a common complication of laparotomy, consisting half of the patients undergoing surgery with the diagnosis of intestinal obstruction. The most common surgeries leading to adhesions and intestinal obstruction were emergency surgeries. Improvements in surgical technique alone will help decrease but not prevent adhesion formation.

Keywords: Adhesion band, Small intestinal obstruction, Etiology of bowel obstruction, Adhesion preventive. Emergency surgery.