Small bowel obstruction.

U 'NLESS there is a compelling contraindication, most surgeons prefer exteriorization to resection and the performance of primary anastbiplosis in the presence of strang-dating obstruction of the small intestine. The chief compelling indication for a primary anastomotic procedure instead of exteriorization has been considered a high situation of the lesion, a situation in which intestinal fistula is definitely hazardous. During the past 2 years, resection and primary anastomosis have become the procedure of choice at the University of Minnesota Hospitals in the management of small intestinal obstruction complicated by the presence of nonviable bowel, either from strangulation or other cause. This procedure started with an infant of 546 weeks who recovered after resection of a gangrenous intussusceptum, a procedure performed with a background of experience with end-to-end anastomosis in dogs. In subsequent cases patients have been treated in similar fashion, until now 16 consecutive cases (IS patients) have been treated in this