Mechanical intestinal obstruction in atlents with gynecologic disease: A review of 368 patients

Krebs, H B; Goplerud, Dean R.

doi:10.1016/s0002-9378(87)80010-8

Cited by 55 publications

(18 citation statements)

References 9 publications

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“…This recent study supports previous findings highlighting the important risk of SBO following gynaecological laparotomy [2,49,[52][53][54][55][56][57].…”

Section: Small-bowel Obstructionsupporting

confidence: 92%

Postoperative abdominal adhesions and their prevention in gynaecological surgery. Expert consensus position

DeWilde

Trew

2007

Gynecol Surg

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Adhesions are the most frequent complication of abdominopelvic surgery, yet many surgeons are still not aware of the extent of the problem and its serious consequences. While adhesions may cause few or no detrimental effects to patients, in a considerable proportion of cases there are major short-and long-term consequences, including small-bowel obstruction, infertility and chronic pelvic pain. Adhesions complicate future surgery with important associated morbidity and expense-and a considerable risk of mortality. Despite advances in surgical techniques in recent years, the burden of adhesion-related complications has not changed. Adhesions should now be considered the most common complication of abdominopelvic surgery. Adhesiolysis remains the main treatment, despite the fact that adhesions reform in most patients. Developments in adhesion-reduction strategies and new agents now offer a realistic possibility of reducing the risk of adhesions forming and can improve the outcomes for patients and the associated onward burden. This consensus position represents the collective views of 35 gynaecologists with a recognised interest in adhesions. The position is presented in two parts. The first part reviews the published literature on the extent of the problem of adhesions, and the second part considers the opportunities to reduce their incidence. It also provides collective proposals on the actions that European gynaecologists should take to avoid causing adhesions. Importantly it also advises that it is now time to inform patients of the risks associated with adhesion-related complications during the consent process. With increasing evidence to support the efficacy of adhesion-reduction agents to complement good surgical practice, all surgeons should act now to reduce adhesions and fulfil their duty of care to patients.

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“…This recent study supports previous findings highlighting the important risk of SBO following gynaecological laparotomy [2,49,[52][53][54][55][56][57].…”

Section: Small-bowel Obstructionsupporting

confidence: 92%

Postoperative abdominal adhesions and their prevention in gynaecological surgery. Expert consensus position

DeWilde

Trew

2007

Gynecol Surg

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“…Myomectomy is associated with a high degree of adnexal adhesions, especially after incision performed on the posterior uterine wall [24]. Surgical treatment of gynecologic malignancy, such as ovarian cancer debulking surgery, may commonly be associated with intestinal obstruction either by persistent tumor growth or by postoperative adhesions [13, 25, 26]. …”

Section: Gynecologic Considerations and Sterilitymentioning

confidence: 99%

Peritoneal Adhesions: Etiology, Pathophysiology, and Clinical Significance

et al. 2001

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Aim: To summarize the most common etiologic factors and describe the pathophysiology in the formation of peritoneal adhesions, to outline their clinical significance and consequences, and to evaluate the pharmacologic, mechanical, and surgical adjuvant strategies to minimize peritoneal adhesion formation. Methods: We performed an extensive MEDLINE search of the internationally published English literature of all medical and epidemiological journal articles, textbooks, scientific reports, and scientific journals from 1940 to 1997. We also reviewed reference lists in all the articles retrieved in the search as well as those of major texts regarding intraperitoneal postsurgical adhesion formation. All sources identified were reviewed with particular attention to risk factors, pathophysiology, clinical manifestations, various methods, and innovative techniques for effectively and safely reducing the formation of postsurgical adhesions. Results: The formation of postoperative peritoneal adhesions is an important complication following gynecological and general abdominal surgery, leading to clinical and significant economical consequences. Adhesion occur in more than 90% of the patients following major abdominal surgery and in 55–100% of the women undergoing pelvic surgery. Small-bowel obstruction, infertility, chronic abdominal and pelvic pain, and difficult reoperative surgery are the most common consequences of peritoneal adhesions. Despite elaborate efforts to develop effective strategies to reduce or prevent adhesions, their formation remains a frequent occurrence after abdominal surgery. Conclusions: Until additional information and findings from future clinical investigations exist, only a meticulous surgical technique can be advocated in order to reduce unnecessary morbidity and mortality rates from these untoward effects of surgery.

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“…The management of small bowel intestinal obstruction due to postoperative adhesions differs slightly. Some workers had achieved high success rate by simple gastrointestinal intubation of the patient [6][7][8] . Carey and Fabri (1992) 9 recommended that patients that should be managed conservatively are those who had been operated on severally and are known to have dense intestinal adhesions, those with known widespread intra-abdominal malignancy and those who develop obstruction in the early post-operative period.…”

Section: Discussionmentioning

confidence: 99%

“…But it is recommended generally that initial approach to the management of intestinal obstruction from adhesions and bands from previous abdominal surgery is conservative with correction of fluid and electrolyte imbalance and decompression of the distended loops of intestine. 6 Where conservative management fails, surgery must be employed to save the life of the patient. The quick operative intervention in this patient was necessitated by the history of induced abortion with possible damage to visceral organs.…”

Section: Discussionmentioning

confidence: 99%

Intestinal Obstruction from an Adhesion Band Mimicking Peritonitis Due to a Complicated Induced Unsafe Abortion: A Case Report

Chudi¹,

Egwuatu²,

Okidi³

2007

African Journal of Reproductive Health

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Miss E.N. a 19-year old nullipara presented at the Accidents and Emergency unit of the Ebonyi State University Teaching Hospital (EBSUTH), Abakaliki on the 17/5/06 with symptoms and signs of peritonitis from possible uterine and bowel perforation secondary to induced unsafe abortion. At surgery, it was discovered that her problem was due to mechanical small bowel obstruction from adhesion band following appendicectomy two years previously. The case highlights the similarities of its presentation to some of the complications of induced unsafe abortion.

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Mechanical intestinal obstruction in atlents with gynecologic disease: A review of 368 patients

Cited by 55 publications

References 9 publications

Postoperative abdominal adhesions and their prevention in gynaecological surgery. Expert consensus position

Postoperative abdominal adhesions and their prevention in gynaecological surgery. Expert consensus position

Peritoneal Adhesions: Etiology, Pathophysiology, and Clinical Significance

Intestinal Obstruction from an Adhesion Band Mimicking Peritonitis Due to a Complicated Induced Unsafe Abortion: A Case Report

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