English

Abstract

BACKGROUND: The diagnosis and management of patients with mechanical small bowel obstruction in adults is one of the more challenging emergency that a general surgeon can come across. Although the mortality due to acute mechanical small bowel obstruction is decreasing with better understanding of pathophysiology, early diagnosis due to improvement in diagnostic techniques and skillful operative management carries grateful results. Hence, the present study was conducted at KIMS Hospital & Research centre, Bangalore, Karnataka. AIMS & OBJECTIVES: To study the incidence, etiology, presentation, investigation modalities, surgical procedure done and outcome following surgery with complications. MATERIAL & METHODS: The study period was two years including follow-up, comprising of 50 cases in a prospective manner. OBSERVATION& RESULTS: The study revealed that, incidence was more in male sex, most common etiology being adhesions in 30 to 50 years of age, followed by hernias in 4th decade, manifesting in the form of pain abdomen, vomiting, abdominal distension and constipation. All cases were treated surgically depending upon the cause after evaluation. The patients were followed up regularly during which hardly few complications like wound infections and post operative adhesions was found and treated laparoscopically. CONCLUSION: It can be concluded that early operations for dynamic small bowel obstruction is mandatory to avoid the development of peritonitis and systemic sepsis associated with multiorgan failure. INTRODUCTION: Acute Intestinal Obstruction is one of the common surgical emergencies encountered in KIMS Hospital and Research Centre, Bangalore, Karnataka. Intestinal obstruction is reported in ancient literature and is defined as, “Interference in the passage of food, liquids and contents of the intestine either due to mechanical or neurological cause”. It is predisposed by various underlying conditions which are difficult to define preoperatively. There are various etiologies for acute intestinal obstruction from more common causes like adhesions, hernia, malignancy to uncommon conditions like intussusception. Though the classical presentation is pain abdomen, vomiting, constipation and distension of abdomen, it needs a complete understanding of surgical anatomy, pathophysiology, symptoms and signs of obstruction and necessary investigations for diagnosis. In this study analysis of various causes, anatomical and pathological nature, mode of presentation, age factors, investigation modalities, and surgical management, various complications, mortality and outcomes have been discussed. MATERIALS AND METHODS: 50 patients were included in this study done at KIMS Hospital and Research Centre, Bangalore who presented to the OPD and Emergency Department from June 2010 to July 2012. Cases were thoroughly assessed through detailed history to identify risk factors,