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Emergency War Surgery NATO Handbook: Part IV: Regional Wounds and Injuries: Chapter XXX: Reoperative Abdominal Surgery

Specific Reasons for Reoperations: Intestinal Obstruction

United States Department of Defense
Peer Review Status: Internally Peer Reviewed


Postoperative mechanical intestinal obstruction, when present, usually develops within the first two weeks after injury. Early operative treatment has been employed with success; the use of long intestinal tubes having been less helpful. Adhesions and intraloop abscesses are the usual causes of obstruction in these cases. It should be stressed that this complication occurs relatively late and should not be confused with prolonged ileus in the earlier postinjury period. Water-soluble radiopaque iodine compounds such as Gastrografin can be employed to differentiate these two conditions. When administered orally, the contrast material fails to traverse the intestinal tract in mechanical obstruction. In the unobstructed case, the contrast material passes through the intestinal tract within a few hours, as evidenced by serial abdominal roentgenograms or by the initiation of bowel movements.

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