Background Intestinal obstruction is defined as a blockage or partial blockage of the passage of the intestinal contents. It is a potentially risky surgical emergency associated with high morbidity and mortality. Its pattern differs from country to country and even from place to place within a country. Therefore, this study aimed to find out the magnitude, pattern and management outcome of intestinal obstruction in Arba Minch General Hospital. Methods A retrospective cross-sectional study was conducted in Arba Minch General hospital from January 09, 2015, to November 09, 2018. The data collection period was from December 15, 2018, to February 09, 2019. A simple random technique was applied to select 801 study participants. Then, the required data entered into Epi Info version 7.2.1.0 and exported to the statistical package for the social sciences software package version 20 for analysis. The binary logistic regression analysis has been done to determine crude statistical associations between independent variables and dependent variables. Linearity, Multivariate normality and multicollinearity were checked between independent and dependent variables by using scatter plot and Q–Q plot respectively. Variables with a p-value of less than 0.25 in the binary logistic regression analysis were entered into multivariable logistic regression. Statistical significance factors were identified based on a p-value of < 0.05 and with a 95% confidence interval. Result This study revealed that the overall magnitude of intestinal obstruction was 40.60% with 95% CI (34.95–45.95). The magnitude of unfavorable management outcomes and deaths during the study period were 22.3% with 95% CI (18.00–27.00) and 7.1% with 95% CI (4.00–10.00) respectively. Persistent tachycardia 10.3 (3.28–32.42), Dehydration 13.7 (3.34–56.56), elevated serum creatinine 10.2 (1.89–54.94), gangrenous small bowel volvulus 2.7 (1.27–5.84), ischemic bowel 3.4 (1.17–9.81) and perforated bowl 7.68 (2.96–19.93) were significantly associated with the management outcome of intestinal obstruction. Conclusion and recommendation Intestinal obstruction was the most common among all acute abdomen cases and its management outcome highly associated with dehydration. Adequate early preoperative resuscitation and proper post-operative care with appropriate surgical techniques and wound care with sterile techniques would help to reduce further mortality. This could be achieved by increasing public awareness of health-seeking behavior. Moreover, health facilities capable of handling patients with small bowel obstruction should be available within the reach of the community.
Background: Intestinal obstruction is defined as a blockage or partial blockage of the passage of the intestinal contents. It is a potentially risky surgical emergency associated with high morbidity and mortality. Its pattern differs from country to country and even from place to place within a country. Therefore, this study aimed to find out the magnitude, pattern and management outcome of intestinal obstruction in Arba Minch General Hospital.Methods: A retrospective Cross-Sectional study was conducted in Arba Minch General hospital from January 09, 2015, to November 09, 2018. The data collection period was from December 15, 2018, to February 09, 2019. Simple random technique was applied to select 801 study participants. Then, the required data entered into Epi Info version 7.2.1.0 and exported to the statistical package for the social sciences software package version 20 for analysis. Result: This study revealed that the overall magnitude of intestinal obstruction was 40.60% with 95% CI (34.95 - 45.95). The magnitude of unfavorable management outcomes and deaths during the study period were 22.3% with 95% CI (18.00-27.00) and 7.1 % with 95% CI (4.00-10.00) respectively. Small bowel volvulus, sigmoid volvulus and adhesion (bands) accounted for 45.30%, 21.35% and 11.97% of all patterns of intestinal obstructions respectively. Dehydration (p<0.001), persistent tachycardia (p<0.001) and perforated bowl (p<0.001) were highly significantly associated with the management outcome of intestinal obstruction.Conclusion and recommendation: Intestinal obstruction was the most common among all acute abdomen cases and its management outcome highly associated with dehydration. Early resuscitation is recommended to decrease unfavorable management outcomes.
The spleen is a vital lymphoid soft organ located in the left hypochondrium region. It is a multi-dimensional organ that enlarges in all dimensions during some disease conditions. Recently, splenomegaly prevalence has been increasing throughout the world. Due to the lack of attention in clinical practice, splenomegaly has become quite a common problem in all parts of the world. The detection of the spleen by palpation is not approval of enlarged spleen because normal spleen may be palpable. A detailed knowledge of morphometric variations of the spleen is of great value in diagnosing splenomegaly clinically, radiologically, and for surgical procedures. Measurement of spleen size by sonography is important as it gives true result than splenic palpation and for identification of disorders present with enlargement or reduction of the spleen. Therefore, this study aimed to assess the anatomy, sonography, and dimensional variation of spleen among individuals with different sociodemographic and anthropometric measurements. The current study reviews different types of literature conducted on spleen all over the world. The result from overall spleen dimensions review shows measurements vary: spleen length (7–14 cm), spleen width (2–7.5 cm), spleen thickness (2–7 cm), and spleen volume (20–350 cm3). The literature revealed that spleen dimensions are affected by geographical differences, races, nutritional status, physical exercise, and anthropometric measurements. The result from reviews shows that spleen dimensions are larger in males than females. As age increases, spleen dimensions significantly decrease. Spleen dimensions positively correlate with height, weight, body mass index, and body surface of individuals. The spleen dimensions were higher in males than in females and have significant positive correlation with height, weight, body mass index, and body surface area. Clinicians, radiologists, and surgeons should confirm splenomegaly by both palpation and sonography. Spleen dimensions variation due to geographical sex, age, and other anthropometric measurements should be taken into consideration during their clinical investigation. Radiologists should measure all dimensions of spleen rather than the length to rule out splenomegaly correctly.
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