ACUTE OBSTRUCTION OF THE SMALL INTESTINE

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Abstract
NOTWITHSTANDING advances in fluid and electrolyte balance,* antibiotics, gastrointestinal suction, and improvements in surgical techniques, the mortality of acute intestinal obstruction is still relatively high.† Up until the last few years the mortality rate was reported to be between 15 and 20% in many leading surgical clinics of this country (Table 1). In spite of much experimental and clinical work on the subject, many questions remain unanswered, and this disease remains a major problem in surgery.14 In attempting to lower the mortalityrate in this condition it is desirable to analyze such series of cases, seeking the answers to such questions as these: (a) How can an early and accurate diagnosis be made? (b) Can a distinction be made between a simple obstruction and one with early strangulation? (c) How frequent and important is the factor of strangulation? (d) What additional factors contribute to the high mortality? (e) When

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