[Small bowel obstruction and adhesions in general surgery at Gabriel Toure University Hospital].

UNLABELLED: The objectives were to determine the frequency, to describe the clinical, therapeutic aspects and to evaluate the cost of the assumption of responsibility of occlusions by supports and or adherences. It was about a retrospective study carried out in the department of surgery general of the CHU Hôpital Gabriel TOURE from January 1st, 2002 to December 2008. Were included in this study all the patients operated for occlusion of hail on Brides and Adherence confirmed in per operational. We colligé 659 acute obstructions of the bowels whose 100 occlusions of hail on supports and adherences is a frequency of 17,8%. They were 55 men (55%) and 45 women (45%). The sex-ratio was of 1,2. The average age was 39,7 years with the extremes varying between 15ans and 80 years. Eighty eight of our patients had surgical antecedents including 14 (16%) of surgery known méso colic and 74 (84%) of surgery under méso colic. Twelve patients had antecedents of contusion and untreated abdominal infections. Among the signs of the occlusive syndrome, the abdominal pain was found at all the malades100 (100%), the vomiting (98), the stop of the matters (88) and the gases (80). The ASP was carried out at 98 of our patients and 74 (75,5%) presented radiological images in favor of the occlusion of hail. The leading cause of occlusion was the supports (67), the supports and adherences (18) and adherences (15). The small intestine was hyperhémié chez14 patient, was necrosed among 16 patients and normal in the 70 cases. The surgical treatment consisted with a section of the support among 60 patients Adhésiolyse among 15 patients, a Adhésiolyse section among 10 patients, a résection Iléostomie among 10 patients and a résection - immediate anastomosis among 5 patients. The rate of morbidity was of 28%, it related to the infection of the operational site 18cas, the digestive dent 6cas and the eventration 4cas. Mortality was of 8%. Intermediate duration of hospitalization 14,8 days. The average costs of the assumption of responsibility were of 156.900 francs CFA.

CONCLUSION: Mortality and postoperative morbidity are not negligible. Gravity of this pathology underlines the interest of it's fast assumption.