[Late post-operative adhesive small bowel occlusions. About 258 cases].

This retrospective study reports a series of 258 patients operated on for late developing post-operative adhesive occlusions. The impact of anterior interventions on these occlusions. The impact of anterior interventions on the occllusions as well as he clinical and paraclinical patterns are discussed before any approach to the different therapeutic aspects of this complication. Previous surgery had an impact not by number of the operations performed (80% of patient had undergone only one intervention on the pelvis or abdomen) but essentially by the nature of the opertions since most of the adhesions occured following surgery on the appendix. The diagnosis should be made urgently ont basis of findings yielded by physical examination and plain abdominal x-rays (ct-scan of the abdomen is hardly indicated for the absence of hydroaeric levels on the plain abdominal film does not defintely exclude the strangulation). Laparoscopic adhesiolys is an adegnate treatment in case of a single adhesion. This laparoscopic is an adegnate treatment in case of a single adhesion. This laparoscopic procedure practised on 11 patients had to be transformed in 3 cases in to an open laparoctomy. Resection rate was 11.6%. Mortality and morbidity rates were 2% and 17% respectively.