POST APPENDECTOMY ADHESIVE SMALL INTESTINAL OBSTRUCTION, IS CONSERVATIVE TREATMENT OF VALUE

Aim: This study ivas a trial to predict which has to be done, to give a chance for conservative treatment or to operate immediately in patients presented ivith post-appendectomy adhesive intestinal obstruction. Methods: This is a hospital based retrospective study. The files of patients admitted to the Suez Canal University Hospital for adhesive intestinal obstruction from 1996 to 2006 were retrieved and studied. Results: Fifty seven patients zvith post-appendectomy adhesive small intestinal obstruction ivere admitted in that period. Forty nine (86%) patients were operated upon; forty one of them (83.7%) had complete obstruction with single band adhesion, twenty seven (55%) patients had complicated obstruction needed intestinal resection, the other 22 (45%) patients had simple adhesiolysis. Eight (14%) patients improved zvith conservative treatment. No mortalities were encountered but 20 (74%) patients of those zvho had intestinal resection developed significant postoperative zvound infection. Conclusion: post-appendectomy adhesive small intestinal obstruction is a serious, unpredictable complication. It is usually complete obstruction caused by tight single band adhesion zvith unexpected spontaneous resolution. Early operative intervention is recommended strongly zvith post-appendectomy adhesive intestinal obstruction. Clinical assessment is of zveak value in differentiating betzveen simple and complicated obstruction