Abstract:

Diagnosis and treatment of acute intestinal obstruction from single center：A report of 267 cases        ZHU Li-jing, HAN Xu, QIN Xin-yu, et al. Department of General Surgery, Zhongshan Hospital Fudan University; Research Institute of General Surgery of Fudan University, Shanghai 200032, China
Corresponding author: LOU Wen-hui, E-mail:wenhuilou@aliyun.com
Abstract    Objective    To analyze the clinical spectrum, diagnosis and treatment of acute intestinal obstruction in Zhongshan Hospital Fudan University. Methods    The clinical data of 267 cases of acute intestinal obstruction admitted from January 1, 2011 to December 31, 2012 in Department of General Surgery, Zhongshan Hospital Fudan University were analyzed retrospectively. Results    There were 267 cases diagnosed with acute intestinal obstruction including 141 cases (52.8%) of adhesive intestinal obstruction and some other causes followed by colon tumor (49 cases, 18.4%), rectal tumor (17 cases, 6.4%), all types of hernia (10 cases, 3.7%), peritonitis (7 cases, 2.6%), intestinal obstruction by gallstone, meconium and persimmon bezoar (7 cases, 2.6%), and other rare causes (36 cases, 13.5%). The top three kinds of previous surgery leading to adhesive intestinal obstruction were listed as followed: 46 cases (32.6%) of colorectal tumor resection, 28 cases (19.9%) of subtotal gastrectomy or total gastrectomy, 21 cases (14.9%) of appendectomy. Of 141 cases of adhesive intestinal obstruction, 82 cases (58.2%) were required surgical intervention eventually, and the remaining 55 cases (39.0%) were received conservative treatments and recovered. Conclusion    Adhesive intestinal obstruction is the leading cause of acute intestinal obstruction in the cases from Zhongshan Hospital Fudan University. Resection of colorectal cancer is the most common cause of adhesive intestinal obstruction. More than half cases of all adhesive intestinal obstruction need reoperation.

Key words: intestinal obstruction, colorectal carcinoma, adhesive intestinal obstruction

摘要：

目的    分析复旦大学附属中山医院急性肠梗阻的疾病谱和诊断治疗方式。方法    回顾性分析复旦大学附属中山医院普外科2011-01-01至2012-12-31收治的267例急性肠梗阻病人的病例资料。结果    267例中，粘连性肠梗阻141例（52.8%），其他导致肠梗阻的病因分别为：结肠肿瘤49例（18.4%），直肠肿瘤17例（6.4%），各类疝10例（3.7%），腹膜炎7例（2.6%），胆石性、粪石性、柿石性肠梗阻7例（2.6%），其他少见病因36例（13.5%）。导致粘连性肠梗阻的前次手术中，位于前3位的分别是：结直肠肿瘤切除术46例（32.6%）、胃大部或全胃切除术28例（19.9%）、阑尾切除21例（14.9%）。141例粘连性肠梗阻中82例（58.2%）最终需手术治疗，55例（39.0%）保守治疗成功。结论    在复旦大学附属中山医院急性肠梗阻的病人中，粘连性肠梗阻是急性肠梗阻的首要病因。结直肠肿瘤切除术是导致粘连性肠梗阻的最常见原因。>50%的粘连性肠梗阻最终需再次手术治疗。

关键词: 肠梗阻, 结直肠肿瘤, 粘连性肠梗阻