Acute small bowel obstruction to adhesions. Indications and results.

Postoperative adhesions are the first cause of small bowell occlusion in de velopped countries. Nevertheless no progress was done in prevention and tre atment of this disease. The aim of this trial is to report results of 276 s mall bowell occlusions caused by adhesion recently operated and consecutive between first january 1993 and 31 december 1996. These patients had 400 pr evious surgical procedures, within 67,4% infra mesocolic or pelvic. 15,1% o f previous surgical procedures took place less than one year before and 36% less than 5 years. Thirty five per cent of patients were operated during 2 4 hours following admission. 23,2% of patients had a digestive resection, c aused by necrosis or iatrogenic dissection. Operative mortality was 4,3% wi thout resection and 16,6% with resection. Progress are warranted to reduce the rate of redux of occlusion and mortality and morbidity in this benign d isease: more peri operative attention and place of laparoscopy should be co nsidered.