Clinical study of surgical management of acute intestinal obstruction in the adults

Abstract

Background: Acute Intestinal obstruction is defined as an obstruction in forwarding propulsion of the contents due to mechanical or neurological causes. Present study was aimed to evaluate the etiology, clinical presentation, surgical management and outcomes in patients with acute intestinal obstruction at our tertiary care hospital. Material and Methods: Present study was retrospective study conducted in patients >18 years age, diagnosed as case of intestinal obstruction, underwent emergency laparotomy for acute intestinal obstruction. Results: In present study, total 92 cases were studied. male predominance (72.83 %) was noted and male to female ratio was 2.68:1. Most common age group was between 41- 50 years (26.09%) followed by 51-60 years (20.65%) and 61-70 years (16.3%) age group. In present study most common sign and symptoms were abdominal tenderness (89.13 %), abdominal pain (85.87 %), vomiting (83.7 %), abdominal distension (75 %) and constipation (60.87 %). In present study most common etiology noted was adhesive obstruction (41.3 %), obstructed inguinal hernia (27.17 %), incisional hernia (9.78 %) and sigmoid volvulus (6.52 %). Other less common causes were ileocecal tuberculosis (3.26 %), ascending and descending colon growth (3.26 %), rectum/anal canal growth (3.26 %), sigmoid colon growth (2.17 %), internal hernia (2.17 %) and intussusception (1.09 %). Adhesiolysis + Resection Anastomosis (44.57 %) was most common surgical procedure followed by herniorrhaphy (36.96 %) and resection anastomosis (15.22 %). Sepsis (15.22 %), urinary tract infection (13.04 %), wound infection (11.96 %), basal atelectasis (6.52 %) and burst abdomen (6.52 %) were common complications noted in post-operative period. In present study 9.72% mortality was noted. Conclusion: Success in the treatment of acute bowel obstruction depends mainly on the early diagnosis and efficient management and treating the pathological effects of the obstruction as much as the treatment of the cause itself.