الفهرس | Only 14 pages are availabe for public view |
Abstract The incidence of adhesions complicating abdominal surgery is of concern to all surgeons. Adhesions are major problem for all surgeons. Peritoneal injury, from a variety of causes, leads to peritoneal inflammation and with the production of plasminogen activator inhibitors. These inhibitors results in the loss of normal mesothelial fibrinolytic activity and, if prolonged, this allows the organization of fibrinous adhesions into permanent fibrous adhesions. Management of these adhesions-related clinical problems result in a large surgical workload and cost to health care system. Nevertheless, considerable controversy still exists concerning the ideal therapy for adhesive intestinal obstruction and the indications for and the timing of surgery. The main problem is how to avoid strangulation or other forms of bowel damage and still minimize the use of unnecessary operations. The present study was undertaken to determine diagnosis and management strategy for adhesive intestinal obstruction. The study had included thirty patients of post-operative adhesive intestinal obstruction admitted to the Surgical Casuality Unit of minia university hospital, all cases were subjected to the following: I. History taking. II. Clinical examination. Routine laboratory investigations and also investigations to confirm the fluid and electrolyte status. Radiological investigations: Repeated abdominal X-ray studies (erect and supine). Repeated abdominal ultrasonographic studies. Abdominal computed tomography scanning enhanced with oral gastrografin contrast. After clinical and radiological evaluation, two groups of patients were identified: Simple adhesive intestinal obstruction. Complicated adhesive intestinal obstruction. |