Assessment of complications and outcomes of mechanical bowel obstruction in a military hospital

Abstract

Aims: Mechanical bowel obstruction is a frequent surgical emergency and a frequently confronted burden in abdominal operation. This study aimed to find out the model of mechanical bowel obstruction in the Iranian population. Methods and materials: In this study, all patients with clinical and radiological evidence of mechanical bowel obstruction that admitted to the Department of Surgery of Baqiyatallah Hospital with a diagnosis of mechanical bowel obstruction from January 2012 to December 2015 were included. The age, gender, symptoms operative details, postoperative complications, outcome, and mortality, were recorded. Results: 193 patients with mechanical bowel obstruction were admitted in our study. Regarding the clinical presentation of the patients, the absence of passage of flatus and/or feces with abdominal pain (65.8%) were the most common presenting symptoms. Adhesions, colonic volvulus, hernias, different types of colorectal cancer were the most frequent causes of obstruction (54.9%, 15.54%, 7.2%, and 9.8%, respectively). Twenty-one patients died, resulting in a mortality rate of 10.9%. In the 19 patients with colorectal cancer, 7 (31.6%) patients have died and cause of death in all them related to cancer disease. Conclusion: The results showed that the most common mechanisms of intestinal obstruction were adhesions, volvulus, cancers, and hernias, respectively, and the most common risk factors were appendectomy history, herniation surgery history, and cholecystectomy history, respectively. About 21 patients (10.8%) underwent obstruction surgery with a diagnosis of malignancy, which was confirmed in 19 cases of tumor pathology, of which about one third had recurrence within 3 years.