WHAT ARE THE SMALL-BOWEL OBSTRUCTIONS TO OPERATE AND HOW TO DO IT

Small bowel obstruction is one of the main surgical emergencies. CT sc an is today the best exam to detect occlusions requiring an urgent sur gical procedure. It also specific the cause of the obstruction. Post-o perative adhesions are the first etiology and justify 3.5-5% of laparo tomies in Western Countries. Recently, small bowel obstructions due to adhesions could be treated bg a laparoscopic procedure. The authors r eport a series of 35 patients presenting an acute small bowel obstruct ion treated by laparoscopy. The laparoscopic procedure was successful in 70% of casts when occlusion was due to acute adhesions. Compared wi th open procedure, coelioscopy had an immediate benefit on intestinal mobility re-establishment and hospital stay. The morbidity was 4.5% wi th no mortality. CT has to be part of pre-operative check-op in front of a small bowel obstruction in order to propose a laparoscopic proced ure when post-operative adhesions are suspected.