الفهرس 
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Abstract
Adhesive intestinal obstruction is responsible for one of the most common emergencies in general surgery, and is also a major cause of morbidity and financial expenditure worldwide (Cooper and Thiriby, 2002). Common causes of adhesive intestinal obstruction have changed considerably over the last 100 years with hernias accounting for 80% of all cases in the early 1900s and adhesions accounting for 60-80% in the year 2000 (Brochwicz-Lewinski et al., 2003). Ancient Egyptians, known for their detailed descriptions of human anatomy, described pelvic adhesions even centuries before. Although adhesiosn caused by peritonitis have been recognized since the early 1700s, it was not until the widespread use of anesthesia in the mid- 1800s that more invasive abdominal procedures became more prevalent and the extent of the problems caused by intra-abdominal adhesions was realized (Becker and Stucchi, 2004). Intraperitoneal adhesions, a common long-term sequela after abdominal operations, can develop in up to 94% of patients, increasing postoperative morbidity and leading to adhesive intestinal obstruction, chronic pelvic pain, and infertility. Complications related to adhesions are costly, and 1994 alone saw an estimated 303,836 hospital admissions, with more than $1.3 billions spent in the United States for the management of these complications (Prushik et al., 2007). Adhesions have been well documented as the leading cause of adhesive intestinal obstruction, especially in the old patients with a history of previous abdominal surgery. Between 49% and 74% of small bowel obstructions are caused by intra-abdominal adhesions (Pickleman, 2006). Considerable controversy still exists concerning the ideal therapy for adhesive intestinal obstruction and the indication for and the timing of surgery. The main problem is how to avoid strangulation or other forms of bowel damage and still minimizing the use of unnecessary operations. Biondo et al. (2003) recommended surgery for any patient with complete intestinal obstruction to prevent the risk of strangulation, and reserve conservative treatment for patients with partial obstruction. Kapoor et al. (2006) suggested that patients with complete or partial postoperative adhesive intestinal obstruction may be managed conservatively for 5 days, provided that there are no obvious signs of intestinal strangulation