Internal intubation of the small intestine for preventing ileus in peritonitis and recurrent adhesions
Waclawiczek, H.W.; Henkel, M.; Rieger, R.
Zentralblatt für Chirurgie 112(19): 1222-1227
1987
ISSN/ISBN: 0044-409X PMID: 3687270 Document Number: 300394
Preventive intestinal intubation for ileus prophylaxis in cases of diffuse peritonitis and extended adhesion ileus had often been discredited for the technically demanding and thus time-consuming technique involved. Yet, tube-related complications in the context of tube insertion or removal can be minimised by the experienced surgeon who stringently observes a number of precautions and provided that the indication had been accurate. Fifty-three intestinal intubations on 49 patients were accompanied by three iatrogenic perforations intraoperatively and by four instances of postoperative fistulation of the small intestine which, however, were all properly controlled by suturing or conservative action. Ileus recurred in three patients because of too early tube removal and due to progressive peritonitis against the background of inadequately cured primary disease and due to peritoneal mesothelioma in one case. Periods of intestinal intubation ranged from six to 14 days. Postoperative lethality was relatively high (30.6 per cent) and had been exclusively caused by progressive sepsis or cardiopulmonary insufficiency. It amounted to 50 per cent of all cases of diffuse peritonitis and only to 4.7 per cent of patients with recurrent adhesion ileus.