Other etiologies of intestinal obstruction were colonic malignancy (n = 2), internal hernia (n = 1), and gallstone ileus (n = 1). Incarcerated hernias consisted of 9 cases of femoral hernias, 4 cases of inguinal hernias, 2 cases of obturator hernias, and 1 case of incisional hernia. Among the cases of intestinal perforation, 5 cases were small intestinal perforations and 9 cases were large intestinal perforations. The most common cause of intestinal perforation was incarcerated

hernia (n = 4), followed by colon diverticulitis (n = 3). Gastro − duodenal perforations were found in 5 cases of perforated duodenal ulcer, 3 cases of perforated gastric ulcer, 1 case of duodenal perforation due to gallbladder cancer invasion, and 1 case of iatrogenic gastric perforation caused by guide-wire of a long tube using for intestinal obstruction. Treatment

All patients were treated surgically. Seventy-six patients (80.9%) underwent emergency surgery SB202190 within 48 hours after admission; the other 18 patients were first treated conservatively and then operated on more than 48 hours after admission. The most common operation was intestinal resection (n = 30), followed by cholecystectomy (n = 24), repair of intestinal adhesion (n = 15), and hernia repair (n = 14). Of the 30 patients treated with intestinal resection, large bowel resection was applied to 17 patients, and small bowel resection to 13 patients. Cholecystectomy was performed laparoscopically in 3 patients, and using laparotomy in 21 patients. www.selleckchem.com/MEK.html There were only 3 cases of palliative surgery; 1 ileostomy for transverse colon perforation, 1 peritoneal lavage for acute pancreatitis, and 1 gastroduodenostomy for advanced gallbladder cancer. Twenty-three patients (24.5%) were followed in the intensive care unit

after surgery. Of these, 20 patients needed mechanical ventilation for respiratory support. Morbidity and mortality Forty-one patients (43.6%) had post − operative morbidity. The most frequent complication was Ribonucleotide reductase surgical site infection (SSI), which occurred in 21 patients (22.3%), followed by pneumonia in 12 patients (12.8%). Sepsis occurred in 5 patients (5.3%), DIC in 5 patients (5.3%), and ARDS, acute renal failure, anastomosis leakage, and urinary tract infection occurred in 2 patients (2.1%) respectively. Of the 12 cases of pneumonia, more than half (8 patients) were aspiration pneumonias. Fifteen patients (16.0%) died within 1 month after their operation. The most common causes of death were sepsis related to pan-peritonitis in 5 patients (5.3%), and pneumonia in 4 patients (4.3%). The other etiologies of mortality consisted of 2 cases of cancer, 1 multiple organ failure, 1 intraperitoneal bleeding due to DIC, 1 renal failure, and 1 suffocation. These complications are listed in Table 2. Table 2 Forty-one patients (43.6%) had post-operative morbidity   Patient (n = 94) % Morbidity 41 43.6 SSI 21 22.