Acute Obstructive Ileus as a Late Postoperative Complication of Peptic Ulcer Disease

Abstract

Objective: To improve the results of surgical treatment of patients with acute intestinal obstruction caused by phytobezoars. Material and Methods: A retrospective analysis of the results conducted by the treatment of 60 patients with acute intestinal obstruction, caused by phytobezoars who were hospitalized in the 2 - clinic of the Tashkent Medical Academy from 2005 to 2015. It should be noted that phytobezoars occurred mainly in patients who previously underwent surgery for complications of gastric and duodenal ulcers. Results: 12 patients (20%), intestinal obstruction were resolved conservatively. The rest underwent operations. Patients who have surgery performed on the small intestine, for the purpose of decompression were set nasoenteral tube, which was removed on 2-3 days after operation. Postoperatively developed the following complications: postoperative wound seroma (2 cases), festering wound (1 case), postoperative pneumonia (2 patients), which were cropped with conservative therapy. One patient on the 2nd postoperative day developed intestinal obstruction, which resolved conservatively. Length of hospital stay were from 6 to 9 days. No deaths were observed. Conclusions: Acute intestinal obstruction caused by phytobezoars meets several times more common in people undergoing surgery for peptic ulcer disease and its complications. It should be noted that most of these patients had no capability information about phytobezoars after such surgical interventions. The diagnostic algorithm is necessary to include endoscopy for diagnosis of gastric bezoar and assess the possibility of its endoscopic removal.