MECHANICAL INTESTINAL OBSTRUCTION CAUSED BY ABDOMINAL WALL HERNIAS

Mechanical intestinal obstructions form important part of pathologies those necessitates emergent surgical intervention. Length of time between symptoms and surgery, preference of surgical procedure and prevention of recurrence are still under discussion. While the most frequent etiological factor is postoperative adhesions in developed countries, strangulated hernias are more common in developing countries. In this study, among 147 cases operated on with the diagnosis of mechanical intestinal obstruction between 1993-1999, 80 strangulate were 50 males (%62,5) and 30 females (%37,5). Mean age was 59 years (range 4-94). The most frequent type of hernia was inguinal hernia and observed in 49 cases. Small intestine was detected most frequently in hernia sac. In 14 cases (%17,5), beside hernia repair, additional surgical interventions were performed. Total morbidity was %22,5 and mortality was %7,5. Patients with mechanical intestinal obstruction should be evaluated for abdominal wall hernias because of high incidence of tried surgical intervention have high morbidity and mortality rates, elective surgery should be recommended when abdominal wall hernia is diagnosed.

KARIN DUVARI FITIKLARINA BAÐLI MEKANÝK BARSAK TIKANMALARI

Barsak týkanmalarý acil cerrahi giriþim gerektiren önemli patolojilerdendir. Tedavisinde seçilecek cerrahi yöntem, giriþim için geçen süre ve tekrarýnýn önlenmesi gibi sorunlar güncelliðini korumaktadýr. Etyolojide geliþmiþ ülkelerde postoperatif yapýþýklýklar ön sýrada iken geliþmekte olan ülkelerde boðulmuþ fýtýklar ön plandadýr. Bu çalýþmada 1993-1999 yýllarý arasýnda kliniðimizde mekanik barsak týkanmasý tanýsý ile opere edilen 147 olgudan 80 boðulmuþ karýn duvarý fýtýðý retrospektif olarak deðerlendirildi. 80 olgunun 50'si (%62.5) erkek, 30'u (%37.5) kadýn ortalama yaþ 59 (4-94) idi. Ýnguinal herni 49 vaka ile en sýk sebepti. Fýtýk kesesi içinde en sýk ince barsaklar tespit edildi. Olgulardan 14'üne(%17,5) fýtýk onarýmý dýþýnda ek cerrahi giriþim uygulandý. Toplam morbiditemiz %22.5 mortalitemiz %7.5 olarak tespit edildi. Barsak týkanýklýðý bulgularý ile baþvuran hastalarda fýtýk noktalarý dikkatle muayene edilmelidir. Acil giriþimlerde morbidite ve mortalite oranlarý yüksek olduðundan karýn duvarý fýtýðý saptanan hastalara elektif cerrahi giriþim uygulanmalýdýr.