title: Intestinal obstruction in patients with previous laparotomy for non-malignancy.
abstract: BACKGROUND
  Intestinal obstruction is one of the most common surgical emergencies. The aim of this study was to identify important management information from the evaluation of patients with intestinal obstruction who had undergone previous laparotomy for non-malignancy.
  
  
  METHODS
  Data from 176 patients with previous laparotomy for non-malignancy, and who were operated on for intestinal obstruction, were collected and analyzed retrospectively.
  
  
  RESULTS
  Gastroduodenal operations, appendectomy, and obstetric/gynecologic procedures were the 3 most common previous abdominal surgeries. More than half of all bowel obstructions developed within 10 years after previous laparotomy, and particularly within the first 5 years. Most obstructions were related to adhesion, although their etiologies were diverse. The rate of bowel strangulation was much higher in patients with internal herniation, volvulus, intussusception, closed loop, and diaphragmatic hernia than in patients with simple adhesion, bezoar, tumor, and inflammation (48.3% vs 12.2%). The surgical mortality rate correlated significantly with bowel strangulation: the overall rate was 6.8%, that in patients with strangulation was 18.8%, and that in patients without strangulation was 4.2%.
  
  
  CONCLUSIONS
  The etiologies of intestinal obstruction were not only significantly related to bowel strangulation, but were also an important determinant of therapeutic strategy.
authors.affiliation: Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C. nhchou@isca.vghks.gov.tw
authors.forename: Nan-Hua
authors.initials: NH
authors.lastname: Chou
authors.forename: Nan-Song
authors.initials: NS
authors.lastname: Chou
authors.forename: King-Tong
authors.initials: KT
authors.lastname: Mok
authors.forename: Shiuh-Inn
authors.initials: SI
authors.lastname: Liu
authors.forename: Being-Whey
authors.initials: BW
authors.lastname: Wang
authors.forename: Ping-I
authors.initials: PI
authors.lastname: Hsu
authors.forename: Cheng-Chung
authors.initials: CC
authors.lastname: Tsai
authors.forename: I-Shu
authors.initials: IS
authors.lastname: Chen
authors.forename: Ming-Hsin
authors.initials: MH
authors.lastname: Yeh
authors.forename: Yu-Chia
authors.initials: YC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology*; D007813:Laparotomy / Q000009:adverse effects*; D008875:Middle Aged