A CLINICAL STUDY AND MANAGEMENT OF ACUTE INTESTINAL OBSTRUCTION

Abstract

Aims And Objectives: The current study aims to review the various causes, clinical features and the outcome of surgical procedures in relation to etiological factors in 50 intestinal obstruction patients admitted at Government general hospital ,Kurnool july2020 –july2022. This study was done on 50 cases of acute intestinal obstruction Materials And Methods: that presented to emergency department of government general hospital,Kurnool(july 2020-july2022).All patients with provisional diagnosis of acute intestinal obstruction were assessed clinically in detail after admission. Investigations done included Hb, Blood counts including TC, DC, ESR, serum electrolytes ,X-ray Chest PA view, Plain X-ray abdomen erect lm & Ultrasonography abdomen, CECT abdomen. . The commonest Results: age group affected was 31-40 years. M:F ratio is 2.6:1. In our patients, the main cause of obstruction was obstructed hernia (36%). Adhesions and bands (26%) were the second most common cause of intestinal obstruction followed by sigmoid volvulus (12%), TB abdomen (8%) and malignant obstruction (6%). Surgery was the mainstay of treatment, with herniorraphy, adhesiolysis and resection - anastomosis being the most commonly performed procedures. Post-operative complications noted were wound infection (12%), respiratory infection (6%) and prolonged ileus (6%). In the present study of 50 cases, 5 patients (10%) died due to septicemia,leak and MODS. The incidence of intestinal Conclusion: obstruction is more common in males, Mode of presentation also differs in different levels of intestinal obstruction, Adhesions accounted for majority of small bowel obstruction (26%),Malignancies are common causes of large bowel obstruction.Early recognition and timely intervention is important to prevent the bowel going for gangrenous changes.Morbidity was due to anastomotic leak, would infection, chest infection. Prognosis was poor in elderly patients and , in patients with co-morbid conditions, presence of strangulated bowel that required resection & anastomosis and those whose presentation to hospital was late