STUDY OF CLINICAL EVALUATION OF INTESTINAL OBSTRUCTION

Abstract

Introduction: All over world Intestinal obstruction is a common surgical emergency. Intra-abdominal problems are one of the most common as Intestinal Obstruction by general surgeons in their practice. Intestinal obstruction is defined as obstruction in forward propulsion of contents of the intestine either due to active or inactive or pseudo-obstruction. It is predisposed by varying underlying abnormality diseases that are difficult to define pre-operatively. About 12% to 16% of acute abdominal emergencies may be contributed to intestinal obstruction. With multiple etiologies for intestinal obstruction of either the small or large bowel which become to be a major cause of morbidity and mortality. There are various Mode of presentation for intestinal obstruction underlying various cause in each age group. In ancients period mortality and morbidity was very high. Nowadays due to improvement and understanding of pathophysiology, diagnosis techniques of radiology, electrolyte imbalance and high degree of refinement in correction of fluid, introduction of antibiotics to effective bacteriological control, introduction of techniques in gastrointestinal decompression, introduction of new surgical principles and primary anastomosis has replaced staged procedures and number of days stay in hospital with caring and with Improvement in field of anesthesia has all contributed to decreasing the morbidity and mortality. About 5 to 15% of cases of severe abdominal pain were due to Mechanical obstruction acquiring sudden onset requiring admission to hospital. Therefore all factors are making difference in outcome of any operative procedure in relation to morbidity and mortality. Patient with acute intestinal obstruction depends largely upon early diagnosis which is useful for success in treatment. Most of the mortality occurs in elderly age with late treatment and who are having associated pre-existing diseases like, diabetes mellitus, COPD and cardiac diseases. However intestinal obstruction is most often the result of colorectal malignancies and lesions usually arise in the sigmoid or recto sigmoid area. 
 Aim: The main aim of this study is to explore different modes of presentations of intestinal obstruction in different age group.
 Material and method: All patients are informed consents. Total 50 patients having intestinal obstruction with various problems were taken in this study attending to hospital as in patient department (IPD) and outpatient department (OPD) of our hospital. A clinical study of intestinal obstruction were selected has to come across this surgical emergency and treatment and skillful management in surgery department of our hospital. The patients with age group 0-80 years were included in this study.
 Result: In this study of 50 cases of intestinal obstruction was studied during period of 1 year. The study was done in all age groups with a mean age of 35 years. Occurrence of intestinal obstruction was common in male (72%) as compare to female (28%). Maximum presenting symptoms in this study was pain abdomen (80%) followed by vomiting (72%), Tenderness (86%), distension of abdomen (56%) and constipation (52%), most of patients with overlapping of symptoms.
 Conclusion: Intestinal obstruction is more common in males compared to females. Mode of presentation also differs in different levels of intestinal obstruction. Adhesions accounted for majority of intestinal obstruction. Intestinal obstruction was found more common in children than other age groups. Malignancies are also common causes of intestinal obstruction. The clinical examination stressed upon vital signs and abdominal examination and Routine necessary investigations were carried out. Hence early recognition and timely intervention is important to prevent the intestinal obstruction. 
 Keywords: Intestinal obstruction, Intussusception, adhesions, hernia, intraperitoneal malignancy.