A study of surgical management and its outcome in adult patients with intestinal obstruction

Abstract

Background: Intestinal obstruction (IO) is one of the most common surgical emergencies, for which the therapeutic strategy has evolved progressively. The aim of this study was to assess the etiology, clinical spectrum and the outcome after surgical management of IO in adult patients.Methods: A prospective, observational study was conducted in adult patients admitted for IO and undergoing surgical management. All patients underwent routine haematological investigations, urine examination (routine and microscopic) and ultrasonography abdomen and pelvis. Specific investigations like serum amylase levels, X-ray abdomen and pelvis (supine and erect) and computed tomography scan were done, if indicated. Treatment modality was confirmed once definitive diagnosis of IO was made. All treated patients were observed for postoperative complications. They were followed up after 7 days and one month postoperatively.Results: In this study, the mean age of patients was 45.8 years and 60% were males. The most common cause of IO was found to be postoperative adhesions followed by paralytic ileus. Out of 80 patients of IO, 50 required surgical intervention, majority of which were treated with release of adhesions (38%) and resection anastomosis (44%). Poorer outcomes were observed in cases of malignancy and mesenteric ischaemia. Mortality (14%) was mainly due to complications like septicemia and respiratory tract infection.Conclusions: The commonest cause of IO in our study was postoperative adhesions. Poor outcome of the disease was associated with late presentation to the hospital, which had high incidence of bowel damage with associated faecal contamination of the peritoneum.