Archampong E Q, Naaeder S B, Darko R
Department of Surgery, University of Ghana, Medical School, Accra, Ghana.
Hepatogastroenterology. 2000 Jan-Feb;47(31):185-93.
BACKGROUND/AIMS: Over the past 50 years acute intestinal obstruction has remained among the commonest causes of the acute abdomen, along with peritonitis, appendicitis and gastrointestinal perforations. However several observers have noticed over the past 2 decades a shift in the etiological spectrum. The study aims at ascertaining the precise nature of the change.
Published data on intestinal obstruction from the Korle Bu Teaching Hospital over the past 50 years were reviewed, as the consistent report format permitted ready comparison of the series. Emphasis was placed on clinical features, established cause and resulting complications.
The case load of intestinal obstruction has dwindled over the past 3 decades, accounting for 0.7% of all hospital admissions compared with 1.4% 30 years earlier. External hernias together with adhesive bands still constitute the bulk of presenting cases, but the proportions have changed with strangulated hernias accounting for 59.8% instead of 77.6%. The change has paralleled a rise in elective hernia day case surgery. The incidence of intussusception has almost doubled (7.4% from 4.0%) and it still afflicts the very young. Colonic neoplasms have been commoner over the past 2 decades although the incidence (3.3%) falls short of Western figures. Overall mortality has remained unchanged at 9.4% and this has been associated with a rise in resection rates to 18.3%.
The patterns of intestinal obstruction have been much influenced by changing attitudes regarding elective hernia surgery and evolving financial policies.
背景/目的：在过去50年里，急性肠梗阻一直是急腹症最常见的病因之一，与腹膜炎、阑尾炎和胃肠道穿孔并列。然而，在过去20年里，一些观察家注意到病因谱发生了变化。本研究旨在确定这种变化的确切性质。
回顾了过去50年里科尔勒布教学医院关于肠梗阻的已发表数据，因为一致的报告格式便于对该系列进行比较。重点关注临床特征、确定的病因和由此产生的并发症。
在过去30年里，肠梗阻的病例数量有所减少，占所有住院病例的0.7%，而30年前为1.4%。外部疝和粘连带仍然是主要的就诊病例，但比例发生了变化，绞窄性疝占59.8%，而不是77.6%。这种变化与择期疝日间手术的增加并行。肠套叠的发病率几乎翻了一番（从4.0%升至7.4%），且仍主要发生在幼儿身上。在过去20年里，结肠肿瘤更为常见，尽管发病率（3.3%）低于西方国家。总体死亡率保持在9.4%不变，这与切除率升至18.3%有关。
肠梗阻的模式受到对择期疝手术态度的变化和不断演变的财政政策的很大影响。
