Subacute intestinal obstruction: an enigma revisited

Abstract

Sixty-three patients presenting with subacute intestinal obstruction (SAIO) were studied. Thirty (47.6%) reported recurrent symptoms. Exaggerated bowel sound, visible/palpable bowel loops, distention of abdomen and abdominal lumps were observed in 60.3%, 28.5%, 25.3% and 19.0% patients, respectively. Thirty (47.6%) required emergency laparotomy. Investigations revealed lesions requiring surgery in 14 of 33 patients which were relieved with conservative treatment. The accuracy of ultrasonography, contrast enhanced computed tomography (CECT) scan and diagnostic laparoscopy was 57.1%, 100% and 100%, respectively. Ileum was the most common site of obstruction (79.5%). Adhesions and small intestinal strictures were the two most frequent cause of obstruction seen in 31.8% and 27.2%, respectively. Tuberculous pathology was demonstrated in 23 (52.2%). Previous abdominal surgery was found to be the only predictor of the success of conservative treatment (13/19 versus 7/44). All patients of SAIO, whose symptoms were relieved with conservative treatment, and who do not have history of abdominal surgery, should be subjected to CECT and/or diagnostic laparoscopy in order to discover the underlying cause of the obstruction. When these diagnostic modalities are not available, laparotomy is an effective alternative for this group of patients.

Clinical Profile and Outcome of Sub Acute Intestinal Obstruction. A Descriptive Cross-Sectional Study

“…Out of which 40% patients (40%) had laparotomy for gynecological conditions while 33.33% patients had open appendectomy and 16.67% had undergone colorectal surgeries. In a others studies about 50% and 32% patients had undergone previous abdominal surgery 11 which is less when compared to ours.…”

“…In our study abdominal distention was present among 32% patients which comparable to finding in another study which was 28.5%. 11 It was found that abdominal tenderness was present among (8/50) 16% patients and most of them 6 out of 8 underwent laparotomy with resection and anastomosis. Therefore, patients who have abdominal tenderness must be monitored carefully as there are increased chances of operative interventions in these groups of people.…”

Intestinal obstruction in a tertiary care centre in India: Are the differences with the western experience becoming less?

“…Shaikhet al reported these strictures in 8.3% of their patients with intestinal obstruction [ 27 ]. A recent study from India has reported these strictures to be the cause in 27.2% although the exact cause is not known ischaemia might be the most common etiology with most strictures localized to ileum and jejunum [ 28 ]. Lalwani et al from our department have also shown the ileum to be the most common site in patients with post-traumatic strictures which probably develop after the segmental blood supply is compromised due to injury to the mesenteric vessels [ 29 ].…”

Intestinal obstruction in a tertiary care centre in India: are the differences with the Western experience becoming less?

“…A recent study from India has reported these strictures to be the cause in 27.2% although the exact cause is not known ischemia might be the most common etiology with most strictures localized to ileum and jejunum. [27] Lalwani et al from our department have also shown the ileum to be the most common site in patients with post-traumatic strictures which probably develop after the segmental blood supply is compromised after injury to the mesenteric vessels. [28] Since malignancy was a frequent cause, adjuvant radiation treatment was responsible for strictures in 12 patients.…”