[Mechanical bowel obstruction. Surgical problem at the turn of the XIX-XX century, and the XX-XXI century. One institutional experience].

Comparative analysis was done between a group of 193 patients operated on for mechanical bowel obstruction at the end of the XIX century (prof. A Obalifiński's clinical material), and a group of 207 patients with the same condition operated on between 1.01.1999 - 31.12.2003 (own clinical material). Both groups were operated on at the same surgical institution. A hundred years ago, and at present mechanical bowel obstruction has been appearing (depending on a patient's sex), in the 1:1 relationship. In both analysed periods two third of the patients developed small bowel obstruction, and one third large bowel obstruction. At the end of the XIX century mean age of the operated patient was 41 years. It was equal to the mean survival time span for the general population at that time. The patients operated on at present were about 25 years older. However their mean age is significantly lower compared with the actual mean survival time span for the general population observed now in Poland. In small bowel the main cause of obstruction has still been an incarcerated abdominal hernia (increase from 30.7% up to 55%), followed by intraperitoneal adhesions (increase from 29.5% up to 34.5%). However their etiology has changed, recently all of them are postoperative adhesions. At the end of the XX century we observed significant drop (from 16.8% to 2.7%) in strangulation of the small bowel mesentery as a cause of obstruction. In case of large bowel during the last century there was a definitive change in frequency of different etiological factors causing obstruction. In the XIX century 72% of them was caused by mesentery strangulation of sigma or cecum. whereas at present over 80% of them is caused by cancer. We presented Prof. A. Obaliński's and his associates scientific output, as they were genuine precursors of mechanical bowel obstruction surgery in Poland.