Epidemiology and causes of intestinal obstruction in Ethiopia: A systematic review

Abstract

Objective: This systematic review was aimed to address the prevalence and causes of intestinal obstruction in Ethiopia. Methods: Systematic searches were conducted on PubMed, EMBASE, CINAHL, Scopus, African Journals Online, HINARI, and other supplementary sources, including Google Scholar. We conducted methodological quality assessments for the articles by employing a critical appraisal checklist of Joanna Briggs Institute. Results: The reported prevalence of intestinal obstruction in Ethiopia ranges from 18.6% to 50.7% among patients with acute abdomen. However, the prevalence varies from 4.3% to 34.6% among total surgical admissions. The leading causes of small intestinal obstruction were small bowel volvulus, intussusception, and adhesion. Sigmoid volvulus was the most commonly reported cause of large intestine obstruction, followed by colonic cancer. Conclusion: The highest reported prevalence of intestinal obstruction in Ethiopia was 50.7% among patients with acute abdomen and 34.6% among surgical admissions. Small intestine volvulus and sigmoid volvulus were the common causes of small and large bowel obstructions, respectively. Therefore, clinicians have to consider the common causes during the diagnosis and management of intestinal obstruction.

Ileoileal knotting a rare cause of double loop small bowel obstruction, diagnostic and intraoperative challenge at Ethiopian Leku district hospital,sidama region, April 2023 ,case report

“…Bowel knots are the unusual causes for bowel obstruction among others ileo-ileal knotting are the rarest reported causes for SBO.In my knowledge and review only 14 such cases were reported worldwide and only 3 cases in Ethiopia all of which were managed in specialized hospitals and managed by specialist physicians. (1,2,3) But in our case it was managed in one of our district hospital in Ethiopia and the leading surgeon was IESO who is a holder of MSc in integrated emergency surgery,dully known in Ethiopia and licensed to do obstetrics,gynecology and general surgical emergencies. For last 10yrs IESOs in Ethiopia were performing tremendous emergency surgical activities in primary health institutions in the country where still the physician specialists are scarce.…”

Left sided gallbladder and liver without situs inversus and recurrent sigmoid volvulus after alleged previous total sigmoid resection; a case report and review of literatures

“…Intestinal obstruction is one of the commonest causes of acute abdomen carrying significant mortality if not intervened timely. In a systematic review done among Ethiopian hospitals, the prevalence of bowel obstruction ranges from 18 to 50 % among patients with acute abdomen [8] . Sigmoid volvulus is one of the common causes of large bowel obstruction more happening in the adults and elderly.…”

“…Adhesion for small bowel and carcinoma for large bowel are commonest causes of obstruction in developed nations but volvulus is commonest cause of obstruction in countries like Ethiopia which may be related to the dietary habit [6] , [7] . Sigmoid volvulus is the commonest cause of large bowel obstruction in Africa and particularly in Ethiopia [8] . Sigmoid volvulus can develop years after suboptimal resectional treatment for sigmoid volvulus [9] .…”

Ileoileal knotting a rare cause of double loop small bowel obstruction,diagnostic and intraoperative challenge at Ethiopian Leku district hospital,sidama region,April 2023 ,case report

“…Ileosigmoid knotting is the commonest and ileoileal knotting is the unusual and only reported in few cases. (1,3) District hospitals in Ethiopia are primary level hospitals and usually the surgical unit is lead by Integrated Emergency surgical o cers( IESO) who is dully known in Ethiopia and the IESO is a postgraduate professional trained for 3yrs and authorized to do emergency obstetrics, gynecologic and emergency general surgeries. It was task shifting professional license allowing to do emergency surgeries in district Ethiopian hospitals where there is scarce physician specialists.…”