Abstract Obstruction of the small intestine comprises about 20% of all acute surgical admissions and is one of the most common surgical emergencies. Approximately 9,000 people die annually in the United States of bowel obstruction.9 In the past four decades the mortality has progressively and markedly fallen. In the early part of the century mortalities of 30% to 50% were not uncommon.1-3 More recent reports indicate that the rate has fallen to 15% and lower.4-6 In the series under consideration a mortality of 4.6% was found. Factors responsible for this decrease in the mortality include better understanding of fluid and electrolyte disorders and their treatment; intelligent use of nasogastric and intestinal intubation; and the use of antibiotics. The importance of early diagnosis and treatment has been stressed for many years and all series show a marked increase in mortality associated with delay in treatment and particularly with the References 1. Tuttle, H.K.: Mortality of Intestinal Obstruction: Study of 150 Cases Coming to Operation or Autopsy , Boston Med Surg J 192:791-795 ( (April) ) 1925.Crossref 2. North, J.P., Acute Intestinal Obstruction , International Clinic 3:206-215 ( (Sept) ) 1929. 3. Brill, S.: The Mortality of Intestinal Obstruction: Analysis of 124 Cases Operated at Hospital of University of Pennsylvania , Ann Surg 89:541-548 ( (April) ) 1929.Crossref 4. Smith, G.A.; Perry, J.F.; and Yorihiro, E.C.: Mechanical Intestinal Obstruction: A Study of 1252 Cases , Surg Gynec Obstet 100:651-660 ( (June) ) 1955. 5. Tendler, M.J., and Cartwright, R.S.: Acute Intestinal Obstruction: A Reevaluation of Therapy: A Review of 31 Years at a University Hospital , Louisiana Med Soc 108:4-10 ( (Jan) ) 1956. 6. Colletti, L., et al: Mechanical Small Bowel Obstruction , Amer J Surg 104:370-375 ( (Sept) ) 1962.Crossref 7. Silen, W.; Hein, M.; and Goldman, L.: Strangulation Obstruction of the Small Intestine , Arch Surg 85:137-145 ( (July) ) 1962.Crossref 8. Becker, W.: Acute Adhesive Ileus: A Study of 412 Cases With Particular Reference to the Abuse of Tube Decompression in Treatment , Surg Gynec Obstet 95:472-476 ( (Oct) ) 1952. 9. Statistical Abstracts of the United States , US Bureau of the Census, Government Printing Office, 1963, ed 84, p 65. 10. Sperling, L.: Intubation Decompression Therapy in Intestinal Obstruction , Lancet 88:65-70 ( (March) ) 1968.
Archives of Surgery – American Medical Association
Published: Oct 1, 1969