[Acute abdomen as a postoperative complication].

The authors describe 11 cases of acute abdomen they observed during a two-year period mainly after abdominal operations. The male/female ratio was 6:5, the mean age 59 years with a range from 20 to 75 years. The mean period which had elapsed after the primary operation was 18.5 days. The authors describe four cases with ileus due to adhesions, three cases of volvulus of the small intestine, a stress ulcer, gangrenous appendicitis, acute cholecystitis and adnexitis. In general it is assumed that the most frequent acute abdomen during the post operative period is ileus due to adhesions, postoperative pancreatitis or stress ulcers are less frequent. Extremely rarely the cause of complaints is inflammatory acute abdomen of a different nature which is an unexpected finding during surgical revision. It is dangerous due to the atypical course and the fact that symptoms are masked by manifestations of the receding postoperative state. In the literature the aetiopathogenesis of such rare conditions is most frequently associated with impaired tissue perfusion due to an inadequate blood flow, general tissue hypoxia due to hypovolaemia, protracted postoperative shock, rigid vascular walls which are incapable of adequate reaction to acute deviations of circulatory demands. Despite this these conditions develop more rarely than corresponds to the coincidence of these general relatively frequent adverse factors. Severe immunosuppression is also observed much more frequently in surgical patients than these rare complications. The authors observed the incidence of these cases of acute abdomen at a ratio of 1:2000 which corresponds roughly to data in published work. Seeking the solution in immunity disorders does not explain this problem.(ABSTRACT TRUNCATED AT 250 WORDS)