Pattern of Mechanical Intestinal Obstruction in Al-Yarmouk Teaching Hospital

Abstract

Background: The effective treatment of patients with intestinal obstruction is essential and requires initial rapid diagnosis and therapeutic intervention . Aim of Study: To determine the causes, the accuracy of preoperative diagnosis, and other epidemiological characteristics of intestinal obstruction in Al-Yarmouk Teaching Hospital in Baghdad, Iraq. Patients and Method: A prospective study was conducted in the Surgical Department of Al-Yarmouk Teaching Hospital for a period of two years (from Jan 1999 to the end of Dec 2000) and included 178 patients admitted and proved to be diagnosed with mechanical intestinal obstruction. Results: Of the 178 patients enrolled in this study; maximum incidence was seen in patients aged between 40-59 years with male predominance (62.4%). Abdominal pain and constipation, were presenting in majority of cases (87.6% and 83.1% respectively). Common causes were hernias, adhesions and bands (35.4% and 28.6% respectively). Small bowel was involved in 69.7% cases and large bowel in 30.3%. Laparotomy was the main option for management (69.1%). The mortality rate was 9.5% and death is associated significantly with aging and volvulus and intussusception as causes of intestinal obstruction. Conclusion: Acute intestinal obstruction still a major cause of morbidity and mortality which was associated with aging, compounda volvulus and intussusception. Hernias and adhesions were the leading causes of intestinal obstruction. Abdominal pain and distension, and constipation were seen in majority of cases. Laparotomy was the most common method of intestinal obstruction management in our institute