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CURRENT PROCEDURE IN MANAGEMENT OF OBSTRUCTION OF SMALL INTESTINE

Clarence Dennis, M.D.
JAMA. 1954;154(6):463-468. doi:10.1001/jama.1954.02940400001001.
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The mortality associated with acute obstruction of the jejunum or ileum has progressively improved since the 40% figures seen before Wangensteen's introduction of nasal suction siphonage. The most recent available figures suggest a mortality rate of about 11%.1 Although the occurrence of ileac obstruction is therefore not as catastrophic now as it formerly was, it still commands a very real risk and is worthy of most thorough consideration.

Failure of the small intestine to transport and handle material normally may be due either to actual mechanical obstruction to the lumen thereof or to paresis of the musculature of the intestine. The latter condition is seen in inflammatory reaction surrounding the involved segment or occurs reflexly in association with such conditions as renal colic or retroperitoneal hematoma. It is with mechanical complete acute obstruction that this paper is concerned.

The anatomical factors underlying such obstruction, in the approximate order of

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