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>LONDON (Reuters Health) Jul 09 - Physicians in the UK have been warned
>that they need to be more aware that patients with abdominal pain who
>have recently undergone surgery may have a potentially dangerous tissue
>adhesion.
>
>The caution comes from a senior surgeon who has investigated the number
>of medico-legal claims against physicians involving adhesions over the
>last decade. Dr. Harold Ellis, from Guy's Hospital in London, found that
>surgical complications are a growing source of litigation.
>
>"Surgeons, gynaecologists and general practitioners must be alert to the
>possibility that obstructive symptoms early and late after abdominal
>surgery are likely to be caused by adhesions," Dr. Ellis writes in the
>July issue of the Journal of the Royal Society of Medicine. "Delayed
>diagnosis can result in gangrene and even perforation of the
>strangulated bowel, with substantial morbidity and mortality."
>
>Along with life-threatening blockages in the small bowel, adhesions can
>cause infertility and severe abdominal pain. Up to 70% of all cases of
>small bowel obstruction are thought to be due to adhesions. One of the
>biggest dangers is that surgery to remove the obstruction carries a high
>risk of further complications, such as perforations to surrounding
>tissue.
>
>Dr. Ellis examined records from the UK's Medical Protection Society
>(MPS) and Medical Defence Union (MDU), medico-legal bodies that
>represent physicians in cases of litigation.
>
>Between 1989 and 1999, MPS records showed that 13 patients had claimed
>damages as a result of adhesions. In nine of these cases, general
>practitioners were accused of delaying or failing to make a diagnosis,
>three were against gynaecologists for missed diagnosis and bowel damage
>during surgery, and one was against a surgeon — again for bowel damage.
>
>MDU data showed there had been 77 claims by patients. Most referred to
>delayed or missed diagnoses, but many cases involved internal injuries,
>pain and infertility. Fourteen of the MDU cases had been settled out of
>court at an average £50,765 per case.
>
>"General practitioners, surgeons and gynaecologists need to be aware of
>the increasing burden of medico-legal claims arising from these
>complications," Dr. Ellis writes. But he stressed it can be difficult
>for GPs to accurately diagnose a blockage because they see so few cases.
>
>"A general practitioner may see one case every 5 or 10 years, or never
>see one at all," he told Reuters Health.
>
>Dr. Ellis added the high risk of adhesions meant patients should
>routinely be informed of the risks before giving consent to surgery.
>Current advice to surgeons is that patients should be notified if there
>is more than a 1% risk of them being damaged.
>
>"In the US, some surgeons video the interview with the patient [just] in
>case, 2 years later, the patient says nobody told them [about the
>risks]," he said. "There are some operations that we know are very
>likely to produce small bowel obstruction. For example, a total removal
>of the colon carries a 25% risk."
>
>He said surgeons might be able to limit the risks of adhesions to the
>small intestine. One way might be to avoid starch-powdered gloves,
>because the powder can come off and create blockages. These gloves were
>commonly used up until the early 1980s, but have since become less
>popular.
>
SWEET KATH, THANKS SO MUCH FOR THIS INFO, AND I PRAY YOUR DAY IS GOING GOOD, INFO TO ME IS KNOWLEDGE, AND IM ONE TO STAND UP, AND BE HEARD..SO I THANK YOU FROM MY HEART..A NEW FRIEND CINDY SHRUHAN.............. cindyandbobby@webtv.net
-- I'M VISUALLY IMPAIRED, I NEED THE CAP'S IN ORDER TO TYPE, NOT TO OFFEND ANYONE..THANKS FOR UNDERSTANDING...