Small-bowel obstruction after restorative proctocolectomy in patients with ulcerative colitis
2007 (English)In: International Journal of Colorectal Disease, ISSN 0179-1958, E-ISSN 1432-1262, Vol. 22, no 6, 637-642 p.Article in journal (Refereed) Published
BACKGROUND AND AIMS: The reported risk of small-bowel obstruction (SBO) after major abdominal surgery varies. The aim of this study was to study frequency and risk factors of SBO after ileal pouch-anal anastomosis for ulcerative colitis. METHODS: Review of the medical records of 188 patients operated with restorative proctocolectomy between 1985 and 1997. All admissions to the hospital were registered and symptoms and X-ray findings consistent with ileus were analysed in relation to preoperative and operative data. RESULTS: SBO was the dominating cause of hospitalization. Forty-eight patients (25.5%) had developed SBO after a median of 76 (range 6-196) months of follow-up, of whom 26 were operated on. The cause of obstruction was adhesion in all but one patient. Early obstruction events were common and accounted for 27% of all operations. Twenty-five of 26 patients who were operated on had a diverting loop-ileostomy compared to 111/162 in the not-operated-on group (p < 0.01). In total, 696 days were spent at the hospital because of SBO. CONCLUSION: SBO is common following pouch surgery and is the dominating cause of hospitalization postoperatively. About 25% of patients developed SBO and half of them needed surgery. The use of a diverting loop-ileostomy was related to an increased risk of surgery for SBO.
Place, publisher, year, edition, pages
2007. Vol. 22, no 6, 637-642 p.
Lleal pouch-anal anastomosis, Restorative proctocolectomy, Small-bowel obstruction, Ulcerative colitis
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-12138DOI: 10.1007/s00384-006-0215-5ISI: 000246446100008PubMedID: 17103178OAI: oai:DiVA.org:uu-12138DiVA: diva2:39907