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J Minim Invasive Gynecol. 2007 Jan-Feb;14(1):64-7.

Partial small bowel obstruction and ileus following gynecologic laparoscopy.

Author information

1
Department of Obstetrics and Gynecology, Northwestern University's Feinberg School of Medicine, Chicago, Illinois 60611, USA. mmilad@nmh.org

Abstract

STUDY OBJECTIVE:

To assess the incidence and management of partial small bowel obstruction (PSBO) and ileus after gynecologic endoscopy.

DESIGN:

Internet-based cross-sectional survey (Canadian Task Force classification II-3).

MATERIAL AND METHODS:

An online survey was distributed to gynecologic surgeons to collect information about frequency and management of ileus and PSBO after gynecologic laparoscopy.

MEASUREMENTS AND MAIN RESULTS:

Of the 58 physician respondents, 22 had managed at least 1 patient with PSBO or ileus after gynecologic laparoscopy. A total of 12 PSBOs and 14 patients experiencing ileus were identified for an overall incidence of 0.036%. Patients showed symptoms between 1 and 20 days postoperatively and had findings ranging from hypoactive (45%), to normal (30%), to hyperactive (25%) bowel sounds. Plain film radiographs (75%) were the most commonly used diagnostic modality followed by computed tomography (CT) scans of the abdomen. Most patients were initially managed with intestinal rest and nasogastric tube placement for 2 to 16 days. Fifty percent required a second procedure, with reported findings that included intestinal herniation (n = 7), bowel injury (n = 4), volvulus (n = 2), and urinoma (n = 1).

CONCLUSION:

Ileus and PSBO are rare findings after gynecologic laparoscopy. We identified 26 cases, most of which were initially managed conservatively. The majority of patients ultimately required a second operation. Surgeons should have a high index of suspicion when managing a patient with PSBO or ileus after gynecologic laparoscopy. Given the findings from the second procedures, CT scans would seem to be the diagnostic procedure of choice.

PMID:
17218232
DOI:
10.1016/j.jmig.2006.07.017
[Indexed for MEDLINE]

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