A clinical study of aetiology of acute intestinal obstruction

Background: Acute intestinal obstruction is one of common abdominal emergency and is associated with significant morbidity and mortality especially if it progresses to bowel ischemia. The diagnosis and management of the patient with intestinal obstruction is one of the more challenging emergencies that a general surgeon can come across. Although the mortality due to acute intestinal obstruction is decreasing with better understanding of pathophysiology and improvement in diagnostic techniques, fluid and electrolyte correction, much potent anti-microbials but still mortality ranges from 10-15% and more so in developing countries.Methods: The study will be conducted in the department of general surgery with symptoms and signs of acute intestinal obstruction admitted in the surgical ward. Fifty cases of intestinal obstruction have been studied. Patients belonged to all the age groups except infants are included in present study. The criteria for selection of cases was based on clinical history, physical findings, radiological and haematological investigations. The study was divided into clinical study, investigations and treatment. The results are tabulated stressing on following points age, sex, symptoms examination findings, investigations, abnormalities, probable causative factors, operative findings and operative procedure adopted and complications if any.Results: The commonest cause of intestinal obstruction in the adults in this study series was postoperative adhesions (36%) followed by obstructed/strangulated hernia (26%). Malignancy of the large bowel was seen in 9 cases constituting 18% of cases where as incidence of Volvulus of bowel was 4% in this series. Although pulmonary tuberculosis is more prevalent in India due to advent in use of antitubercular drugs incidence of abdominal tuberculosis is becoming less. In present study incidence of ileocaecal tuberculosis was 10%. One case of mesenteric ischaemia was present in our study.Conclusions: Acute intestinal obstruction remains an important surgical emergency in the surgical field. Success in the treatment of acute intestinal obstruction depends largely upon its early diagnosis, skilful management and treating the pathological effects of the obstruction just as much as the cause itself.

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A clinical study of acute intestinal obstruction

The American Journal of Surgery ◽

10.1016/s0002-9610(27)90365-1 ◽

1927 ◽

Vol 2 (3) ◽

pp. 278

Keyword(s):

Clinical Study ◽

Intestinal Obstruction ◽

Acute Intestinal Obstruction

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THE PATTERN OF ACUTE INTESTINAL OBSTRUCTION: A HOSPITAL BASED. STUDY..

10.36106/ijsr/8502423 ◽

2019 ◽

pp. 1-3

Author(s):

Sunil Kumar Patanaik ◽

Chaitali Pattanayak*

Keyword(s):

Intestinal Obstruction ◽

Age Groups ◽

Operative Management ◽

Acute Intestinal Obstruction ◽

Common Symptom ◽

Common Procedure ◽

Therapeutic Modalities ◽

Study Results ◽

Obstructed Hernia ◽

Subacute Intestinal Obstruction

BACKGROUND: Intestinal obstruction is a surgical emergency that causes confusion both in the diagnosis and the management. It is related by important disease and mortality. The goal of this study was to classify the etiology, to analyse the methods of performance of acute duodenal obstruction in different age groups, various therapeutic modalities of treatment, to accomplish operative management, anticipate the post-operative complications and outcomes of patients with acute intestinal obstruction. MATERIAL& METHODS: 82 patients of all age groups (except infants) presenting with acute intestinal obstruction were studied between June 2017 and December 2018 in a multispeciality hospital in Eastern India. Patients with history of subacute intestinal obstruction and paralytic ileus were excluded from this study. RESULTS: Males were found to be affected much more than females. Pain abdomen was the most common symptom found in 94% cases followed by distension and vomiting in 86.6% and 68.3% cases respectively. Most common etiology of intestinal obstruction was due to adhesion and bands (40.3%) followed by obstructed hernia (22%) and malignancy (17%). The most common procedure done in intestinal obstruction in present study was release of adhesions and bands (37.8%) followed by resection and anastomosis (26.8%). CONCLUSION: Bowel obstruction continues to be one of the most common abdominal problems faced by general surgeons. Success in the treatment of intestinal obstruction depends largely upon early diagnosis, skilful management and treating the pathological effects of the obstruction just as much as the cause itself.

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Clinical Study of Acute Intestinal Obstruction

MVP Journal of Medical Sciences ◽

10.18311/mvpjms/2020/v7i1/18098 ◽

2020 ◽

Vol 7 (1) ◽

pp. 27-34

Author(s):

Hemant Borse ◽

Gaurav Patil ◽

◽

Keyword(s):

Clinical Study ◽

Intestinal Obstruction ◽

Acute Intestinal Obstruction

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Proportion of colonic carcinoma in cases presenting with acute intestinal obstruction: a cross sectional study

International Surgery Journal ◽

10.18203/2349-2902.isj20215135 ◽

2021 ◽

Vol 9 (1) ◽

pp. 81

Author(s):

Pauly T. Joseph ◽

Rajiv Sajan Thomas ◽

Sutharjivel V.

Keyword(s):

Colon Cancer ◽

Intestinal Obstruction ◽

Dietary Habits ◽

Colonic Neoplasms ◽

Acute Intestinal Obstruction ◽

Colonic Carcinoma ◽

General Surgeon ◽

Routine Practice ◽

Common Cause ◽

Obstructed Hernia

Background: Acute intestinal obstruction is one of the most common emergencies encountered by the general surgeon in routine practice. Although historically, obstructed hernia has been the most common cause, recent studies have shown that adhesive intestinal obstruction is now the commonest reason. Malignant bowel obstruction is also on the rise especially with the change in dietary habits. This study aims at identifying the proportion of colonic carcinoma in cases presenting with acute intestinal obstruction.Methods: The patients with acute intestinal obstruction which was diagnosed clinically and radiologically were studied. Based on operative and clinical findings along with investigation results, the etiology was identified. The patients having colonic neoplasms were identified and the data was compared with other etiological factors to find out the proportion of colonic carcinoma in the cases.Results: The proportion of colon cancer in patients presenting with acute intestinal obstruction was around 15%. The most common cause was obstructed hernia followed by post-operative adhesions. Males were more commonly affected than females. Most of the cases underwent operative management. The most common age group affected was around 50-60 years.Conclusions: This study confirms that there is a definite rise in the number of cases of colon cancer presenting as acute intestinal obstruction. There is also a skewing of the age at presentation towards younger age groups. Small bowel obstructions were much more common mainly due to adhesions and obstructed herniae.

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A prospective study of cases of intestinal obstruction and role of conservative expectant management

International Surgery Journal ◽

10.18203/2349-2902.isj20182220 ◽

2018 ◽

Vol 5 (6) ◽

pp. 2191 ◽

Cited By ~ 1

Author(s):

Yuktansh Pandey

Keyword(s):

Intestinal Obstruction ◽

Prospective Study ◽

Conservative Management ◽

Expectant Management ◽

Abdominal Tuberculosis ◽

Acute Intestinal Obstruction ◽

Age Group ◽

Abdominal Adhesions ◽

Tract Infections ◽

A Prospective Study

Background: Intestinal obstruction continues to be a common surgical emergency throughout the world and its management protocol has evolved over years. In our study we aimed to provide a complete epidemiological description of intestinal obstruction in adult age group patients in a tertiary care hospital in Northern India.Methods: This is a prospective study of patients belonging to age group more than 12 years admitted in our unit with clinical features suggestive of intestinal obstruction from September 2011 to December 2013 at R. N. T. Medical College, Udaipur. The study comprised of 134 patients.Results: Intestinal obstruction contributed to 6.5% of all surgical admissions. It was nearly twice more common in males. 43% patients presented with features of acute intestinal obstruction in comparison to 57% who presented with features of sub-acute intestinal obstruction. Most common cause observed was obstruction due to intra-abdominal adhesions followed by abdominal tuberculosis 48 and 29 percent respectively. Features of intestinal obstruction resolved in 60% patients with conservative management. Adhesions, abdominal tuberculosis and malignancy counted for majority of patients with sub-acute obstruction. Emergency surgery was done in 32% of patients and 36.5 % of patients were discharged non-operatively. Planned Surgery after successful expectant management was done in 24 % patients. Most frequently seen complication was wound site collection (72.5%) followed by respiratory tract infections (49%). Total mortality in our study was 12.6% of which 41% was post-operative mortality and 59% mortality seen in patients who expired during conservative management. Conclusions: This study demonstrates that intra-abdominal adhesions and abdominal tuberculosis account for most cases of intestinal obstruction in countries like India. A watchful expectant management can be tried in patients with prior operative history and those with history of tuberculosis.

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