Abstract
Cases presenting with intestinal perforation and obstruction constitute a substantial work load on our surgical service. Etiologies vary in underdeveloped and developed countries. Histopathological examination of resected intestine is expected to provide the definite evidence of the underlying etiology- guiding a better health care planning for preventive measures. Our objective was to study the spectrum of histopathological findings in resected intestines from cases of intestinal obstruction and perforation in our local population to document the underlying etiology. A total of 120 cases of intestinal resection were included. Detailed gross and microscopic examination with routine stains was performed. Definite evidence of any specific etiology on the basis of morphology was documented. A total of 95 cases with clinical/radiological diagnosis of obstruction (79.2%) and 25 of intestinal, perforation (20.8%) were included. Tuberculous enteritis was the commonest etiology (n=41; 43.1%) in cases of intestinal obstruction followed by malignant tumours (n=30; 31.5%). ischemic infarct/gangrene, post op illeal adhesions, polyps and ulcerative colitis followed. In cases of perforation, Typhoid enteritis (n=15; 60%), was the commonest pathology followed by idiopathic perforation (n=5; 20%), tuberculous enteritis (n=3;12%), carcinoma (4%) and ulcerative coliti (4%). Conclusion : In developing countries infective etiology remains a dominant cause of intestinal obstruction and perforation. Its presentation in younger age leading to intestinal resection demands effective preventive measures in this part of the world to prevent morbidity and mortality.
Highlights
A wide range of pathologies can inflict both small and large intestines. Such patients may present with features of acute intestinal obstruction or perforation
In developed countries the most common cause of small bowel obstruction is post-operative adhesions followed by volvulus and intussusception.[2]
How much can a routine histopathological examination be helpful in finding out the etiology in a resected intestine? We hope to answer these questions in the present study. In this prospective study 120 intestinal resection specimens from patients presenting with clinical or radiological features of intestinal obstruction and perforation between January 2012 to April 2013 were included
Summary
A wide range of pathologies can inflict both small and large intestines. Clinically, such patients may present with features of acute intestinal obstruction or perforation. Intestinal resection remains the sole management option for these patients.[1] The causes of acute Intestinal Obstruction vary demographically.[2] In the developing world, for small intestines infections like tuberculosis account for more than half of all cases of small bowel obstruction.[3] In developed countries the most common cause of small bowel obstruction is post-operative adhesions followed by volvulus and intussusception.[2] The causes of large bowel obstruction are varied again These include tumours, diverticulitis, volvulus or fecal impaction. Its presentation in younger age leading to intestinal resection demands effective preventive measures in this part of the world to prevent morbidity and mortality
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