A clinical study of acute intestinal obstruction : Meyer, Karl A. and Brams, William A.Illinois M. J., Jan., 1927, li, 43

Abstract

INTRODUCTION : Intestinal obstruction is defined as any hinderance to the passage of intestinal contents. It may be classified as dynamic and adynamic obstruction. Dynamic obstruction is one of the most serious and frequently encountered emergencies presenting as acute abdomen. The present study is conducted with objectives to find out the frequency of various etiological factors of intestinal obstruction and to evaluate the morbidity and mortality in adult patients presenting with intestinal obstruction. AIMS AND OBJECTIVES : 1. To study incidence and various etiology of intestinal obstruction. 2. To study the various modes of presentation, importance of early diagnosis and management. 3. To study the role of imaging studies in determining site and etiology. 4. To study the morbidity and mortality rate in acute intestinal obstruction. MATERIALS AND METHODOLOGY : All patients who presented with symptoms and signs of bowel obstruction, admitted and managed surgically from June 2014 to June 2016 in the Department of General Surgery are included in this study. Diagnosis is based on the history, clinical findings, and supported by ultrasonography and radiological studies (plain x-rays) in all patients. Final diagnosis is made at exploratory laparotomy. Inclusion Criteria : 1. All patients presenting to emergency department with features of intestinal obstruction and are treated surgically. 2. Patients in the age group 15 to 75 years. 3. Patients who are haemodynamically stable. Exclusion Criteria : 1. Patients presenting with subacute intestinal obstruction and treated surgically. 2. Paediatric age group patients. CONCLUSION : This study on acute intestinal obstruction was aimed at studying the age and sex distribution, various etiologies, clinical presentations, treatment and outcomes of acute intestinal obstruction. Acute intestinal obstruction remains to be one of common surgical surgeries. Males are commonly affected mostly during their fifth decade. Obstructed/strangulated inguinal hernia remains to be the most common cause followed by adhesions. They usually present with abdominal pain with multiple air fluid levels in their X-ray abdomen erect view. The initial management of patients with acute intestinal obstruction should focus on aggressive fluid replacement, decompression of the obstructed bowel, and on prevention of aspiration. Surgery remains the cornerstone of treatment. Earlier diagnosis and timely intervention are associated with excellent prognosis. Delayed diagnosis leading to strangulation and increased age are associated with poor outcomes.