Abstract
As an index for diagnosis and treatment of adhesion ileus, ultrasonographic (US) grading of the disease was attempted and its usefulness was studied. eighty-seven patients with adhesion ileus except for two of non-adhesion received US diagnosis between January 1987 and February 1992.
The findings were tentatively divided into four grades: Grade I, subileus; Grade II, simple ileus; Grade III, strunglation ileus without intestinal infarction; and Grade IV, strunglation ileus with intestinal infarction. The grading was made depending on the signs of intestinal dilatation, wall thickness, Key board appearance, peristalisis, movement of intestinal content and existence of ascites. The decision making in the treatment was done according to the grades. Subsequently, the results were as follows: decompression therapy was effective in 63 (74%), medical therapy was finally success in 58 (68%), surgical treatment was done in 27 (32%) including 17 of emergentcy laparotomy. There was no death in this period. The accuracy on diagnostic grading of ultrasonographic finding became 95% (83/87). In conclusion, ultrasonographic grading for accurate decision making is extremely useful in the treatment of adhesion ileus.
