przy Oddziale

Międzyleski Szpital Specjalistyczny w Warszawie






Ileus: analisys of location, causes and spectrum of performed operations
Maciej Wleklik, Sławomir Poletajew, Omar Tayara
Students' Scientific Society of General and Vascular Surgery, Miedzyleski Specialist Hospital in Warsaw
Supervision: Krzysztof Paterkiewicz MD
Chief: Waldemar Kostewicz Ph MD

Intestinal occlusion ileus is serious clinical matter, requiring urgent surgical treatment. Spectrum of operation depends mainly on the cause of ileus and it’s location.

The aim of the study was estimation of levels and causes of alimentary tract obstructions and spectrum of performed operations.

Material and methods.
The group of 256 cases (144 women, 112 men, avg age 66,7 years) have been retrospectively investigated concerning operations of ileus performed in Miedzyleski Specialist Hospital in Warsaw in years 1985-2007. In the group levels and causes of ileus and spectrum of performed operations were estimated.

Most ileus occurred in jejunum and ileum (52%) and main cause were adhesions between the loops of intestine and structures of abdomen and pelvis (44%, avg age 60 years) and tumors (28%, avg age 66,9 years), then incarceration of intestine in hernial sac (15% avg age 69,4 years). In large intestine obstruction occurred mostly in the sigmoid (23%) and in the transverse colon (11%) and the main cause were tumors (78%, avg age 70,3 years), less common were adhesions (10% avg age 69,3 years). Paralytic ileus occurred in 5% of cases.
Operations performed on small intestine mostly consisted of partial resection with anastamosis or with anus exterirization (46%) and adhesions’ deliberations (32%), then reduction of intestine loops from hernial sac and hernioplasty (7%).
Operations performed on large intestine mostly consisted of tumors’ resections (74%) and adhesions’ deliberations (9%). In 3% of cases splenectomy was performed because of operative complications. Partial resection of large intestine was performed in 84% of cases, abdominal anus was exteriorized in 57% of cases.

1. Tumors, are the most common causes of ileus within the elderly patients (avg age 70 years) and adhesions between the intestine and structures of abdomen and pelvis are main causes of ileus within the younger patients (avg age 62 years).
2. Most of the operations of ileus consist of partial resection of alimentary tract.
3. More then half of the operations of ileus on the level of large intestine consist of exteriorization of abdominal anus.
4. Operative complication are rare, most common is splenic haemorrhage, requiring splenectomy.
It is essential to inform patient during the preparation to the operation about probable wide spectrum of operation (including potential exteriorization of anus) and to gain permission for that procedure.

4th International Scientific Congress of Medical Students and Young Doctors
Warsaw, 27th -29th April 2007

Archieves of Medical Science 2007; 1(2), supl.2: S179