[Intestinal ischemia resulting from previous laparotomy].
BACKGROUND
Acute adhesive obstruction of the small intestine is a surgical emergency in which there is a risk of intestinal ischemia. By delaying diagnosis and institution of appropriate treatment for ischemic obstruction, morbidity and mortality increase.
The hospital records of 63 patients with diagnosis of intestinal obstruction and regional ischemia due to fibroadhesive peritonitis were reviewed in an attempt to identify criteria that could be used to separate patients who would require an emergency operation; 39 (61.9%) were male and three (4.7%) newborn. This complication was seen after 3 years of age in 39 patients (69.1%). Appendicitis was first cause with 26 cases (41.2%). Range of time of appearance after operation was from 1 week to 15 years (median 10 months). In 87% of patients the operation was a second procedure. All had gangrene and an enterostomy was constructed. General morbidity rate was 80%. Four children died.


CONCLUSIONS
It is mandatory to identify which patients require non conservative management.
Baeza-Herrera
Carlos
C
Academia Nacional de Medicina, Departamento de Cirugía General, Hospital Pediátrico Moctezuma.
García-Cabello
Luis Manuel
LM
Villalobos-Ayala
Donaciano
D
Domínguez-Pérez
Salomón Tonathiu
ST
Mora-Hernández
Francisco
F
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007410:Intestinal Diseases / Q000209:etiology*; D007415:Intestinal Obstruction / Q000209:etiology; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000209:etiology*; D007813:Laparotomy / Q000009:adverse effects*; D008297:Male; D010538:Peritonitis / Q000209:etiology*; D000267:Tissue Adhesions / Q000209:etiology