English

Abstract

BACKGROUND The commonest surgical emergency worldwide in adults is Acute intestinal obstruction. The commonest aetiology was found to be different in India and the western world and middle east. In the former it was obstructed inguinal hernia and in the later it was adhesions. Among the different diagnostic modalities radiology was accurate in 60 % of the patients. Demography reeled different aetiological factors and diagnostic methods adopted. Aims and Objectives of the Study- To elaborate the demography, clinical features, diagnosis and final outcome in the Adult intestinal obstruction. METHODS 57 patients who underwent exploratory laparotomy for Adult acute intestinal obstruction (AAIO) were studied for their demography, clinical presentation, diagnostic methods adopted and operative findings were noted. The final outcome in the management of AAIO were elaborated. RESULTS The mean age of the patients was 47.30 ± 6.74 years with the youngest patient aged 36 years and the eldest was aged 54 years. Adhesions was the commonest cause for intestinal obstruction in 25 / 57 (43.85 %) obstructed inguinal hernia in 19 / 57 (33.33 %) patients and tumours in 09 / 57 (15.78 %) patients. The mortality rate was 19.29 % (11 / 57) and the complication rate was 35.08 % (20 / 57). Radiological diagnosis was accurate in 26.31 % (15 / 57) of the patients. CONCLUSIONS The major aetiological agent was adhesions in the Adult Acute Intestinal obstruction followed by obstructed inguinal hernias and tumours. The change in the causative factor similar to the western literature was observed. CT abdomen must always be chosen as first choice for diagnosing AAIO before undertaking the surgery. Presence of strangulated bowel during surgery had grave mortality (p value - 0.001). Presence of shock was another factor contributing to the mortality (p – value - 0.021). KEY WORDS Intestine, Obstruction, CT Scan Abdomen, and Abdominal Emergencies