Study of clinical spectrum and management of acute intestinal obstruction

Abstract

Background: Acute intestinal obstruction is one of the major surgical emergencies. Intestinal obstruction is defined as partial or complete interference with forward flow of small or large intestinal contents. Intestinal obstruction of either small or large bowel continues to be a major cause of morbidity and mortality. Study aims to find the aetiology, diagnosis and management of acute intestinal obstruction.Methods: A total of 135 patients of acute intestinal obstruction was studied from November 2013 to October 2015 in government medical college, Nagpur. Study was done in patients in OPD of this tertiary centre. Inclusion criteria being patients coming to the hospital with features suggestive and further confirmed of acute intestinal obstruction. Patients included were in, age group of 18 years to 80 years giving written informed consent. Patient of pseudo obstruction were excluded from the study.Results: A total of 135 patients, presented with acute intestinal obstruction during the period of the study. Mean patient age was 45.87 years with peak incidence in those aged 21-30years. The foremost signs and symptoms were constipation (85.93%) and abdominal pain (91.11%). Adhesions and bands (61.9%) was the leading causes of intestinal obstruction.Conclusions: Present study concluded that small bowel obstruction is more common than large bowel obstruction. Abdominal pain, constipation and distension are the most common symptoms, while increased bowel sounds, tachycardia and tenderness is most common sign. Post-operative adhesion in small bowel and malignancy in large bowel is major cause of acute intestinal obstruction.

Risk factors for Post-operative Complications of Surgical Interventions done in Small Bowel Obstruction (SBO): A study of 100 cases

“…In study conducted by Cole et al most common age group affected was 31-40 years 14. The mean age for SBO was 47.46±13.46 in this study, which varies with 25 and 63.8 years of mean age reported by Drożñdz et al15 and Markogiannakis et al16 respectively but similar to 45.87 years reported by Jaiswal et al17 , and 45 years by Lawal et al…”

“…Sepsis was noted in 4% patients. Septicemia (25.93%) and wound infection (30.37%) were the most common post-operative complications found by Jaiswal et al 17 . Wound infection was the most common post-operative complication in the study by Adhikary et al 12 occurring in 11.99% patients.…”

“…This is similar to the findings of other studies. Jaiswal et al 17 found abdominal pain (91.11%), constipation (85.93%) and abdominal distension (74.07%) were the most common symptoms with which patients presented to emergency department. Markogiannakis et al 16 in their study showed that abdominal pain (74%), vomiting (78.6%) and constipation (90%) formed the major symptoms while the major signs included increase bowel sound (66%), abdominal distention (65.3%) and guarding (37.3%).…”