Etiological factors and mortality of acute intestinal obstruction: a review of 705 cases.
OBJECTIVE
To figure out the etiological factors and overall mortality of the patients with acute intestinal obstruction, and to explore the rational period of conservative therapy before operation.


METHODS
Medical records of all the patients with acute intestinal obstruction admitted to West China Hospital from 1995 to 2002 were retrospectively reviewed. The etiology of the obstruction was categorized, and the correlation of mortality and time interval between conservative therapy and operation was analyzed.


RESULTS
There were 705 patients with acute intestinal obstruction included. There were 71.1% of the obstruction lesions located on the small bowel, and 82.6% of the patients experienced simple obstruction. The most frequent cause was adhesions (62.0%), and next was neoplasms (23.7%). There were 57.6% of the patients underwent the surgical treatment. The overall mortality rate was 1.6%, and the mortality rates in conservative therapy and surgical intervention groups were 1.3% and 1.7% respectively. The intestinal necrosis rate was increased gradually with the prolongation of time interval between conservative therapy and operation, and the death might occur 24 hours after strangulation.


CONCLUSIONS
The epidemiological transition to adhesive obstruction still exists in China, and it is similar to that in Western countries. In our experience, near half of the patients with simple obstruction may achieve palliation by conservative therapy. Surgical intervention is indicated for the patients with prolonged and non-palliated simple obstruction, or strangulation disease within the first 24 hours.
Department of General Surgery, Multi-disciplinary Treatment Team of Gastrointestinal Tumors, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, China.
Xin-Zu
XZ
Chen
Tao
T
Wei
Kun
K
Jiang
Kun
K
Yang
Bo
B
Zhang
Zhi-Xin
ZX
Chen
Jia-Ping
JP
Chen
Jian-Kun
JK
Hu
D000208:Acute Disease; D003131:Combined Modality Therapy; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications* / Q000473:pathology; D007414:Intestinal Neoplasms / Q000150:complications; D007415:Intestinal Obstruction / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D007421:Intestine, Small / Q000601:surgery; D008297:Male; D008516:Medicine, Chinese Traditional / Q000379:methods*; D008517:Phytotherapy; D012189:Retrospective Studies; D013997:Time Factors; D000267:Tissue Adhesions / Q000150:complications*
D004365:Drugs, Chinese Herbal