A Descriptive Study of Clinical Presentation, Etiology and Management in Acute Mechanical Bowel Obstruction

Abstract

Background: Acute mechanical bowel obstruction is a common surgical emergency and a frequently encountered problem in abdominal surgery. It constitutes a major cause of morbidity in hospitals around the world and a significant cause of admissions to emergency surgical departments. Intestinal obstruction belongs to highly severe conditions, requiring a quick and correct diagnosis as well as immediate, rational and effective therapy. Method: This is a prospective observational study which was carried on 130 patients of abdominal obstruction in the department of general surgery Sawai Man Singh Hospital Jaipur. Results: The majority of patients in our study were 31-40 years of age group. Mostly patients were male account about 86.15%. Pain abdomen was the most frequent presenting symptoms (95.38%) and absence of passage of flatus and feces was next complain (89.23%). Nausea and vomiting was present in 84.62% of patients. Abdominal tenderness was the most common physical finding on clinical examination (96.92%). Abdominal distension was present in 81.54% patients. Adhesions and bands were the most prevalent etiology of obstruction in the small bowel obstruction (58.45%) and tumour and volvulus were the most common etiology in the large bowel (12.31%). Conclusion: Intestinal obstruction is most commonly caused by intra-abdominal adhesions, Koch’s abdomen, malignancy and obstructed hernia. Conservative treatment with bowel rest and fluid resuscitation is successful in a variable proportion of patients. Patients with clinical degradation on assessment and radiological scans evoking ischemia or strangulated bowel obstruction need urgent surgery. Keywords: Bowel Obstruction, Pain, Adhesions, Tumour.