Study of Clinical Features, Etiology and Operative Management of Acute Intestinal Obstruction in Adults

Abstract

Introduction: Acute bowel obstruction is an emergency. It should be diagnosed early and treated promptly, if not the patient’s life may be endangered. Hence it is essential for every surgeon to have complete knowledge of this condition. Aims & objectives: To study clinical presentation, various etiologies and management of acute intestinal obstruction in adults. Material and Methods: Present study was a hospital based prospective study conducted over period of 2 years. Hundred patients admitted with acute bowel obstruction were evaluated on basis of detailed clinical history and physical examination. Results: Presenting symptoms were pain (100%), constipation (99%), vomiting (94%), fever in 54% of the cases. Obstipation was least common symptom (40%), distension was next commonly seen sign (89%) followed by abdominal tenderness (100%). Patients with absent bowel sounds were 68%, 18% patients showed evidence of hypotension. Causes of obstruction were: adhesions (27%), obstructed external hernias (19%) followed by volvulus (15%), pseudo obstruction (3%). For postoperative adhesions appendectomy was most common cause (44.44%) followed by gynecological operations and perforation peritonitis. Conclusion: Abdominal pain was most common presenting symptom of acute intestinal obstruction. Most common sign of acute obstruction was tenderness followed by abdominal distention and absent bowel sounds. Small bowel obstruction was more common than large bowel. Most common cause of acute bowel obstruction in adults was adhesions followed by obstructed external hernias and Volvulus. In large bowel obstruction, malignancy was most common cause. Most common procedure performed for acute bowel obstruction in adults was resection and anastomosis followed by adhesiolysis.