Intestinal obstructions complicating peritoneal adhesions at the Lubumbashi University Clinics.

BACKGROUND

Postoperative adhesions are the main cause of adhesive small bowel obstructions (ASBO), which represent a significant health problem with major adverse effects on quality of life. The present study aimed to determine the results of our experience in the ASBO management and to compare them with the reported results in this topic in developed countries.

METHODS

From January 2006 to January 2008, we prospectively enrolled 161 patients suffering from acute mechanical intestinal obstructions at Lubumbashi University Clinics. Among them, there were 62 cases of ASBO. All the demographic, medical, and follow-up data were collected in a standardized data collection form.

RESULTS

ASBO represented 1.6% of all patients admitted to the surgical unit and 35% of surgical abdominal emergencies. ASBO was the leading cause (38.5%) of mechanical bowel obstruction. The average age of the patients was 35 years (ranges: 5-68 years). Postoperative adhesions were the most frequent cause of ASBO. Appendectomy and laparotomy for peritonitis were previous surgeries mostly associated with ASBO. The largest number (41.2%) of ASBO occurred within 2 to 4 years after the first surgery. Our death rate and global complication rate are consistent with those reported in other studies.

CONCLUSION

Postoperative adhesions constituted the first cause of ASBO in our experience in a developing country. Risk factors of ASBO remain unpredictable or poorly understood. Thus, all laparotomy must have useful indication and must be meticulous.