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October 1965

Strangulation Intestinal ObstructionA Clinical Appraisal

Author Affiliations

From the Department of Surgery, Howard University College of Medicine. Assistant Professor (Dr. Leffall), Resident in Surgery (Dr. Quander), and Professor and Head of Department (Dr. Syphax). Dr. Quander is presently a captain in the USAF Medical Corps in Atlanta, Ga.

Arch Surg. 1965;91(4):592-596. doi:10.1001/archsurg.1965.01320160046010

DESPITE the advances made in the diagnosis and management of intestinal obstruction, the mortality rate from strangulation obstruction has not improved significantly during the past 20 years. Zollinger related this static mortality rate to (1) delays in diagnosis, (2) uncertain management after the diagnosis is made, (3) insufficient preoperative preparation, and (4) technical errors.1 Cognizant of this unchanging mortality at our hospital, we undertook a critical analysis of all cases of strangulation obstruction that had progressed to gangrene which occurred in a 15-year period (1949-1963) to ascertain what findings, if any, would permit earlier diagnosis and treatment. All factors in these cases were carefully evaluated to determine their role in such patients.

Clinical Material  Fifty-two cases of gangrenous intestinal obstruction at the Freedmen's Hospital (teaching hospital for Howard University College of Medicine) are included in this study. During this 15-year period, there were approximately 1,700 admissions for intestinal obstruction.

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