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December 1948

ACUTE OBSTRUCTION OF THE COLON: With Special Reference to Factors of Mortality

Author Affiliations

From the Department of Surgery, School of Medicine, Tulane University of Louisiana.

Arch Surg. 1948;57(6):774-790. doi:10.1001/archsurg.1948.01240020784002

THERE is probably no better commentary on the present status of obstructive conditions of the large bowel than Bruusgaard's1 statement in connection with the 13 deaths in the 91 cases of volvulus he was reporting from the Ullevaal Hospital. Fourteen and two-tenths per cent was, he remarked, "a satisfactory rate." It is true that he immediately qualified the remark by saying that it was a satisfactory rate considering the advanced age of most of the patients and the poor physical state of many of them. Nonetheless, the status of a disease can scarcely be regarded as satisfactory if one must be resigned to what amounts to 1 death in every 7 cases, especially if it is remembered that volvulus does not carry the highest mortality rate of obstructive conditions of the large bowel. That dubious distinction goes to malignant obstruction.

Isolated series of cases of acute obstruction of the