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.
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.
LEFFALL LD, QUANDER J, SYPHAX B. Strangulation Intestinal ObstructionA Clinical Appraisal. Arch Surg. 1965;91(4):592-596. doi:10.1001/archsurg.1965.01320160046010