腸管癒着症特に術后腸管癒着症を中心として

The author studied 36 cases of postoperative intestinal adhesions treated in this insitute during the past ten years. The results obtained were as follow. 1) The sex ratio was 21 (male) to 15 (female). 2) Fifty-three percent of the cases ranged from 20 to 40 years in age. 3) The initial operations which supposedly caused the adhesions were appendectomies. 4) Of the primary causative disease of the acute intetinal obstruction group, appendicitis accounted for 62% and gastrointestinal diseases for 15.4%. The primary causative disease of the chronic intestinal obstruction group was found to be appendicitis in about 70% of the cases. 5) The chief complaints made by patients were of vomiting and generalized Severe pain of the abdomen. 6) The most frequent sites of occurrence of the adhesions were the greater omentum, the small intestine and the sutured part of the peritoneum. 7) As regards the final therapeutic approach, in the largest number of cases (36.% of the total) lysis of the adhesion was performed. In most other cases, however, distress was relieved by enterostomy, resection of the bowel, and so on. Finally, the four most recent cases, all of whom suffered from recurrent intestinal obstrution, were relieved of the major portion of their abdominal complaints by a new method, an improvement of the original technique advocated by Noble in 1937. The details of this new technique will be reported in the next issue.

Original Paper