[Recurrent adhesive ileus after surgical treatment of ovarian teratoma, malposition of an intrauterine device and dolichosigmoid--case report] ].
A 30-year-old woman was operated for ovarian teratoma and repeatedly for adhesive ileus during 1995-1999. A partial left ovarectomy, extirpation of an intrauterine device (IUD) in malposition (greater omentum) and appendectomy were performed during the first operation. Early adhesive ileus developed on the fourth postoperative day. Adhesectomy was performed in the region of the terminal jejunum. A new adhesive ileus developed after twenty seven months when patient underwent laparoscopy for gynaecological problems with conversion to laparotomy because of greater adhesions intraperitoneally another adhesectomy was performed. During the next eleven months new adhesive obstructions of the bowel developed and a third operation had to be performed incl. resection of the dolichosigmoideum on account of chronic problems during defaecation. A special tube as a intraluminal splint was inserted as prophylaxis of mechanical ileus in the postoperative period. But during next thirteen months subileous conditions and mechanical ileus developed again (up to now). The picture of intraperitoneal conditions was disastrous: almost total fibrotic changes allowed only partial adhesectomy. The passage through bowel is limited and is restricted to dietetic and medicamentous preparations. This case-report demonstrates postoperative adhesions a very old and very serious problem at the beginning of the third millennium.
Kaska
M
M
Chirurgická klinika FN, Hradec Králové.
Hoch
J
J
Vacek
Z
Z
Louda
B
B
Ryska
A
A
D000328:Adult; D012809:Colon, Sigmoid / Q000002:abnormalities* / Q000601:surgery*; D020878:Device Removal; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology*; D007434:Intrauterine Devices / Q000009:adverse effects*; D009852:Omentum; D010051:Ovarian Neoplasms / Q000601:surgery*; D010532:Peritoneal Diseases / Q000209:etiology; D011183:Postoperative Complications; D012008:Recurrence; D013724:Teratoma / Q000601:surgery*; D000267:Tissue Adhesions