Abstract
Background Small bowel obstruction is a common and dangerous surgical emergency which is associated with high morbidity and mortality if not managed appropriately and timely. Objective To determine the causes and management outcome of small bowel obstruction in Nekemte Referral Hospital, Nekemte, Ethiopia. Method Institution-based retrospective cross-sectional study design was used. Three-year data (from January 1, 2014, to December 30, 2016) were collected from July 1 to August 30, 2017. Data were collected from medical records and checked for any inconsistency, coded, and entered into SPSS version 20 for analysis. Descriptive, binary, and multivariate logistic regression analyses were used. On binary logistic regression analysis, variables with p ≤ 0.25 were selected as a candidate for multivariate logistic regression analysis. The level of statistical significance was set at p ≤ 0.05. Results With 100% response rate, records of 211 patients with small intestinal obstruction were retrieved for analysis. One hundred thirty-seven (64.9%) were males. The commonest cause of small bowel obstruction was adhesion (35.1%). More than a quarter (26.5%) participants developed postoperative complications, and wound infection was the commonest postoperative complication (49.2%). A majority (84.8%) of patients improved and were discharged, and the rest 15.2% of patients died. Sex (AOR = 3.98, 95% CI: 1.51–10.52), duration of illness before surgical intervention (AOR = 4.4, 95% CI: 1.69–11.45), level of hematocrit (AOR = 4.25, 95% CI: 1.56–11.57), types of intestinal obstruction (AOR = 3.73, 95% CI: 1.09–12.64), and length of hospital stay (AOR = 4.69, 95% CI: 1.82–12.07) were independent predictors of the management outcome of patients with small bowl obstruction. Conclusion Small bowel obstruction is a commonly encountered surgical emergency. Adhesion, small bowel volvulus, and intussusception were the leading causes of small bowel obstruction, respectively.
Highlights
Small bowel obstruction (SBO) is defined as blockage of the passage of small intestinal contents from the proximal to distal segment
Small bowel obstruction is a common and dangerous surgical emergency which is associated with high morbidity and mortality if not managed appropriately and timely. e prevalence and causes of SBO differ internationally and locally [2,3,4,5], but it is a serious surgical emergency worldwide, with increased rate of morbidity and mortality. e situation was considered to be worse in developing countries where health facilities were rare and health education was lacking, and numerous patients who present late to hospitals after trials with local remedies were exhausted
Nekemte town is located in Oromia regional state, western Ethiopia, which is 333 kilometers from Addis Ababa. e hospital was established in 1923 EC, providing service for approximately 3 million people in the catchment area including surgery. e study was conducted from July 1 to August 30/2017
Summary
Small bowel obstruction (SBO) is defined as blockage of the passage of small intestinal contents from the proximal to distal segment. It is one of the most common conditions resulting in hospital admissions [1]. Primary small bowel volvulus is one of the other common causes of SBO in parts of Africa. Sex (AOR 3.98, 95% CI: 1.51–10.52), duration of illness before surgical intervention (AOR 4.4, 95% CI: 1.69–11.45), level of hematocrit (AOR 4.25, 95% CI: 1.56–11.57), types of intestinal obstruction (AOR 3.73, 95% CI: 1.09–12.64), and length of hospital stay (AOR 4.69, 95% CI: 1.82–12.07) were independent predictors of the management outcome of patients with small bowl obstruction. Small bowel volvulus, and intussusception were the leading causes of small bowel obstruction, respectively
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