Etiology, Clinical Manifestations, and Imaging Evaluation of Intestinal Obstruction in Adults at Tertiary Hospital in Mogadishu, Somalia: A Retrospective Study.

Abstract

Intestinal obstruction (IO) is a surgical emergency with high morbidity and mortality. The leading causes in adults include adhesions, incarcerated hernias, and tumors. This three-year retrospective study reviewed adult patients with IO treated at Mogadishu Somalia Turkey Training and Research Hospital from June 1, 2019, to June 1, 2022. Of the patients studied, 67% were male, with a male-to-female ratio of 2:1. The most common symptoms were nausea and vomiting (93.2%), abdominal distension (90.2%), and inability to pass stool or gas (70.8%). Surgical management was required for 95.1% of patients, with only 4.9% managed conservatively. The most frequent postoperative complication was surgical site infection. Hospital stays for 52% of patients ranged from 8 to 14 days. The overall mortality rate was 4.9%. IO remains a critical surgical emergency worldwide, requiring urgent intervention. Aggressive treatment of hernias and timely surgical intervention for mechanical obstruction are essential to reduce complications and mortality. Delayed presentations contribute to higher mortality rates. Small bowel obstruction was more frequent than large bowel obstruction, with fibrous adhesions and incarcerated hernias as the leading causes. Adhesiolysis and bowel resection with anastomosis were the most common surgical procedures. Further research using prospective study designs is recommended to improve understanding and outcomes.