Early postoperative small bowel obstruction

Abstract

A prospective study is presented of the clinical features and laparotomy findings in 26 patients who were re-explored for complete mechanical small bowel obstruction which occurred when they were in hospital after abdominal surgery. This complication occurred particularly in patients after colorectal and pelvic surgery and operations for acute appendicitis. Attention is drawn to the fact that small bowel distension occurring after the fourth postoperative day is usually due to mechanical obstruction or intra-abdominal sepsis and rarely, if ever, due to ‘adynamic ileus’. Evidence is presented that plain abdominal radiography is of high diagnostic accuracy in postoperative small bowel obstruction and that early re-exploration of the abdomen and surgical relief of the mechanical obstruction are indicated in these patients.