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Colonic pseudo-obstruction following obstetrical surgery. A review.

Colonic pseudo-obstruction denotes an apparent intestinal obstruction occurring in the absence of a demonstrable lesion or luminal occlusion. This syndrome is distinct from adynamic ileus, and parturition accounts for a major category of reported cases. The purpose of this paper is to 1) review the literature on the subject, 2) emphasize the severity of this condition and the need for early diagnosis and prompt management and, 3) to outline guidelines for the improved management of this disorder.

Cesarean Section↗

[Prevention of thromboembolism with heparin in gynecological and obstetric surgery].

During a period of 28 months 983 gynaecological patients had major abdominal or vaginal operations under Heparin prophylaxis. In no case thrombosis or pulmonary embolism occurred. 5 hemorrhages required surgical revision and temporary reduction of Heparin dose. Global tests for preoperative diagnosis of hemostasis and for postoperative control of Heparin effect are discussed. Possible reactive fibrinolysis under Heparin administration, its complications and control are mentioned. Peri- and postoperative prophylaxis of thrombo-embolism with Heparin in daily dosages up to 20,00 I.U. seems well suitable.

Blood Coagulation Tests↗

Prophylactic antibiotic in elective gynaecological and obstetrical major surgery.

A prospective controlled study of 580 patients who underwent non-radical major gynaecological or obstetrical surgery examined the use of prophylactic antibiotics. The test group of patients (290) showed a significantly lower (P=0.01) incidence of the total complications and the non-infective complication rate as against those among controls (290). The duration of hospitalisation was significantly reduced for both vaginal and abdominal surgery in the test group of patients as against those in the controls. There was no evidence of increased incidence of bacterial resistance or superinfection. The authors recommend the use of prophylactic antibiotic on a short term basis (for a total duration of 4 days), commencing preoperatively to achieve a significant reduction in the infective postoperative morbidity and a shorter stay by the patients.

Anti-Bacterial Agents↗

[Roentgenoendoscopic therapy of ureteral injuries after obstetric-gynecological surgery].

Ureteral injuries as a complication of obstetric-gynecological operations occur in 0.37% of cases and are accompanied by formation of stricture or ureteral obliteration, development of uretero-vaginal fistula. Roentgenoendoscopic technologies offer a new solution of the problem of restoration of ureteral passability and elimination of urogenital fistulas. Roentgenoendoscopic treatment of ureteral injuries was made in 14 patients: for obliteration of the lower third of the ureter in 5 cases, stricture of the lower third of the ureter in 9 cases, stricture in combination with uretero-vaginal fistula. The length of the injury varied from 0.2 to 1.5 cm (mean--0.6 cm). Two patients have undergone optic buerginage of ureteral stricture followed by balloon dilation, 7 patients--optic endoureterotomy, 5--ureteral recanalization. Three patients with ureterovaginal fistulas had one-stage fistula fulguration. The operations finished with internal stenting for 6-18 weeks. Normal urine passage recovered in 12 of 14 (85.7%) patients. The fistula disappeared in 3 patients. Thus, roentgenoendoscopic treatment of ureteral injuries after obstetric-gynecological surgery produce positive results in most cases and raises quality of the patients' life.

Adult↗