A CLINICAL STUDY ON VARIOUS PRESENTATION AND MANAGEMENT OF ACUTE INTESTINAL OBSTRUCTION

Abstract

BACKGROUND: The diagnosis and management of patient with intestinal obstruction is one of the more challenging emergency that a general surgeon can come across. With better understanding of pathophysiology, improvement in diagnostic techniques, uid and electrolyte correction, much potent antibiotics and surgical management the complications arising due to late presentation can be limited. AIMS AND OBJECTIVES: To analyze different modes of presentation, various etiological factors of acute intestinal obstruction and to evaluate the different lines of management and its outcome. METHDOLOGY: This study was conducted in M.B Government Hospital attached to R.N.T. Medical College Udaipur. 50 patients fullling the inclusion criteria were part of this study. RESULTS: Intestinal obstruction is more common in the age group of 41-50 years. Male to female ratio is 2.6:1. Small bowel obstruction is more common than large bowel obstruction. Four cardinal features of intestinal obstruction are pain abdomen, vomiting, distension and constipation. Most common etiological factor is postoperative adhesions followed by abdominal hernia. Malignancy as a cause for obstruction is more common in large bowel than small bowel. Most patients were treated by operative procedure in comparison to conservative management; adhesiolysis (14 cases) was carried out commonly. CONCLUSION: Obstruction due to adhesions is increasing in incidence due to increased abdominal & pelvic surgeries. The obstruction due to external hernias is decreasing due to early elective surgeries. The morbidity and mortality depends on the age of the patient, etiology of obstruction, site of obstruction, state of hydration, viability of the bowel, delay in diagnosis and surgical intervention and associated medical illness. Early diagnosis of possible strangulation will markedly decrease morbidity and mortality.