Clinical Nalysis Of Strangulating Intestinal Obstruction In 137 Cases

To investigate the early diagnosis and the timing of surgery for strangulating intestinal obstruction. The clinical data of 137 cases with strangulating intestinal obstruction from August 1995 to December 2008 were reviewed retrospectively.All cases were treated by operation. 111 cases were cured,26 dead after operation,the total mortality was 19.0%. 96 cases were early diagnosed as strangulating intestinal obstruction before operation, 9 cases(9.4%)died after operation ; the other 41 cases' final diagnosis was clarified by exploratory laparotomy and 17 cases(41.5%) were dead. The mortality of early diagnostic cases was lower. The patients due to delayed admission ,delayed diagnosis, acute mesenteric vascular occlusion and internal abdominal hernia were associated with higher mortality ,the aged and the children as well .The main cause of death was septic shock,MOF,ARDS and acute renal failure.Characteristic of abdominal pain, tender mass, peritoneal irritation sign , shock,abdominal X-ray and CT scanning were the mainstays of early diagnosis of strangulating intestinal obstruction . The patients lacking typical manifestation should be observed and monitored carefully, combining the patients' age , conservative therapeutic responsibility , possible obstructive reason and other factors to aggregate analysis and grasp the timing of operation correctly. Early diagnosis and operation was the key procedure of decreasing mortality.