scholarly journals Study of acute intestinal obstruction management and its outcome

2021 ◽  
Vol 8 (12) ◽  
pp. 3535
Author(s):  
Valarmathi M.

Background: Acute intestinal blockage (AIO) is a common abdominal emergency with a high morbidity and mortality rate. Early blockage diagnosis, skilled operative management, correct technique during surgery and intense postoperative therapy yield superior results. The aim was to study the aetiology, clinical presentation, therapy and outcomes of patients with IO who presented in the emergency department.Methods: This prospective study was conducted at the general surgery department from June 2019 to May 2021. The study comprised 60 patients with IO who presented to the OPD or emergency room and the data was analysed.Results: Among 60 patients with IO, peak incidence was observed in patients above 50 years of age, predominantly among males. Abdominal pain turned out to be the most common symptom of IO in our patients. Patients obstructed in the small intestine were found to be predominant. Post-operative adhesions were the most common cause of IO.Conclusions: Early diagnosis, proper preoperative hydration, fast investigations, and early operational intervention were found to increase survival in patients with intestinal obstruction in the current study.

2018 ◽  
Vol 5 (9) ◽  
pp. 3072
Author(s):  
Shivakumar C.R ◽  
Mohammad Fazelul Rahman Shoeb ◽  
Anil P. Reddy ◽  
Sharangouda Patil

Background: Acute intestinal obstruction is one of common abdominal emergency and is associated with significant morbidity and mortality. Early diagnosis of obstruction, skilful operative management, proper technique during surgery and intensive postoperative treatment carries better results. The aim of this study was to identify the etiology, clinical presentation, management and outcomes of patients with acute intestinal obstruction presenting in GIMS, Gulbarga.Methods: This is a prospective study carried out in the department of general surgery A unit at Gulbarga Institute of Medical Sciences, Gulbarga, from May 2014 to January 2018.  50 patients with acute intestinal obstruction coming to the OPD and emergency department were included in study and data was analysed.Results: A total of 50 patients, presented with acute intestinal obstruction during the period of the study. Mean patient age was 46.5 years with peak incidence in 50-59 years. Small intestinal obstruction was seen more commonly than large intestinal obstruction. Most common etiology of intestinal obstruction was due to adhesion and bands (40%).Conclusions: Present study concluded that Intestinal obstruction is seen more commonly in middle age group. Males were affected twice as common as females. Abdominal pain was the most common symptom, while tenderness was the most common sign. Post-operative adhesion caused most cases of   small bowel obstruction while large bowel obstruction was caused most commonly by malignancy. Earlier the presentation better will be the outcome.


2019 ◽  
pp. 1-3
Author(s):  
Sunil Kumar Patanaik ◽  
Chaitali Pattanayak*

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.


2019 ◽  
pp. 1-3
Author(s):  
Sunil Kumar Patanaik ◽  
Chaitali Pattanayak*

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.


2017 ◽  
Vol 4 (2) ◽  
pp. 485 ◽  
Author(s):  
Pradeep Kumar Chitumalla ◽  
Naresh Kumar Vemulapally ◽  
Surya Narayana Reddy

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 aims of this study was to analyse various modes of presentation of acute intestinal obstruction in both children and adult age group, etiopathogenesis, various therapeutic modalities of treatment and to accomplish operative management and anticipate the post operative complications.Methods: 50 consecutive patients of all age groups presenting with acute intestinal obstruction were admitted were taken randomly and managed between October 2013 to September 2015.Out of these 50 cases, 36 were male, 14 were female, patients with subacute intestinal obstruction and patients with paralytic ileus were excluded in this study. Plain X-ray erect abdomen was done in all cases. Ultrasonography was done only in those patients whose X-ray finding was inconclusive. CT as a modality also included for work up.Results: Mean age distribution was 35.4years and the standard deviation measured 24.57. Incidence in male (36) was more as compared to female population (14). Pain abdomen was found in 45(90%) patients, vomiting in 35(70%) patients, distension abdomen in 34 (68%) patients and constipation in 30 (60%) patients were noted as many patients had coincidence of symptoms. Commonest cause of acute intestinal obstruction noted was postoperative adhesions.Conclusions: Postoperative adhesions were the commonest cause of obstruction. Earlier the presentation, the better the outcome was found.


2011 ◽  
Vol 19 (1) ◽  
pp. 34-37
Author(s):  
Md Moniruzzaman Sarker ◽  
AKM Golam Kibria ◽  
Md Manzurul Haque ◽  
Kali Prosad Sarker ◽  
Md Khalilur Rahman

A case of sub-acute intestinal obstruction due to spontaneous complete transmural migration of a retained surgical mop into the small intestinal lumen has been treated surgically in surgery department of Rajshahi Medical College Hospital. The patient presented with colicky abdominal pain, nausea, occasional abdominal distention and vomiting. She had history of abdominal operation twice previously. Abdominal examination revealed a mobile lump in the right side of abdomen. Diagnosis could be made only at laparotomy.   doi: 10.3329/taj.v19i1.3167 TAJ 2006; 19(1): 34-37


2019 ◽  
Vol 6 (4) ◽  
pp. 1371
Author(s):  
Brajamohan Mishra ◽  
Malaya Krishna Nayak ◽  
Sandeep Mishra ◽  
Itishree Das

Background: Sickle cell disease is one of the common haemoglobinopathies in the world. Among its various clinical presentations, splenic complications are associated with high morbidity and substantial mortality, the only effective preventive strategy for which is prophylactic splenectomy. The aim of the present study was to observe the safety and effectiveness of splenectomy to prevent frequent requirement of hospitalizations, blood transfusions and splenic complications in patients of sickle cell disease.Methods: The study was carried out in 72 patients of SCD with splenomegaly who underwent splenectomy for some indication in the surgery department of VSSIMSAR, Burla during the period from October 2016 to September 2018. Their preoperative baseline hematological parameters and frequency of transfusion requirement was compared with postoperative status.Results: Of these 72 SCD patients, 49 (68.7%) patients had repeated requirement of blood transfusion and hypersplenism, 22 (30.5%) patients had history of one or more episodes of splenic sequestration crises, one patient had splenic abscess. After splenectomy the mean increase in haemoglobin level, TLC and TPC was respectively 2.83±0.9 gm%, 1.7±0.8 lac/cmm and 2726±1618/cmm. Operative mortality was 0%. None of the patients required any blood transfusion and no major postoperative complications during 6 months follow up period.Conclusions: The morbidity of the patients of SCD in terms of repeated hospitalizations, blood transfusion, living with a huge spleen, accompanying symptoms and its complications can be effectively minimized by the elective splenectomy. With good preoperative preparation and post-operative management, splenectomy in SCD patients is a safe procedure with minimal risk of post-operative complications.


Author(s):  
A. V. Sergeev ◽  
A. N. Katrich

In the described clinical case we presented features of a clinical presentation, difficulties of textiloma diagnosis which resulted in acute intestinal obstruction in several years after surgery. The high diagnostic value of an ultrasonic method in diagnostics of foreign bodies was shown.


2020 ◽  
Vol 8 (1) ◽  
pp. 248
Author(s):  
Pradeep Tenginkai ◽  
Parthiban Nagaraj ◽  
Santosh Nayak K

Background: Intestinal obstruction remains one of the most common intra-abdominal problems faced by general surgeons in their practice. Its early recognition and aggressive treatment in patients of all ages, including neonates, can prevent irreversible ischemia and transmural necrosis, thereby decreasing mortality and long-term morbidity. Objective of the study was to study the etiological factors, various modes of clinical presentation and management of intestinal obstruction.Methods: Study was conducted by selection of consecutive 50 cases presenting with symptoms and signs suggestive of acute intestinal obstruction from Chigateri General Hospital and Bapuji Hospital attached to J.J.M.Medical College, Davangere during the period from June 2009 to May 2011.Results: In our series, the maximum incidence is in the age group of 41-50 years. The occurrence of acute intestinal obstruction was common in male compared to female. Small bowel obstruction is more common. The commonest presenting symptom was abdominal pain followed by vomiting, distention of abdomen and absolute constipation. Adhesive obstruction (56%) was the commonest cause of acute intestinal obstruction, followed by Obstructed Hernia (18%), Malignancy (6%), Volvulus (4%), Intussusceptions (6%) and TB stricture (6%). Release of adhesions and bands was done in 22 cases. Resection and end-to-end anastomosis was done in 16 cases, which included cases of intussusception, adhesions, stricture, Ileo-caecal growth, colonic growth.Conclusions: Most common etiological factor for intestinal obstruction is postoperative adhesions. Release of adhesions and bands was the most common surgery done.


2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Guillaume Lafaurie ◽  
James Butterwoh ◽  
Angeliki Iakovou ◽  
Alec Engeldow

Abstract Aims 10% of emergency surgical admissions are due to acute intestinal obstruction. If surgery is required, the mortality is raised to 10%. The latest 2017 National Audit of Small Bowel Obstruction (NASBO) has identified several key investigative and therapeutic targets. Our aim is to look into our clinical practice and compare it to the NASBO standards.  Methods In a district general hospital (DGH), we prospectively collected data of 30 patients coming consecutively with acute small bowel obstruction looking into imaging, conservative management, surgical management and outcomes.  Results 30 patients were included in this study with mean age of 69 years (24-88 years old), with an average hospital stay of 7 days (1 - 46 days). Bowel obstruction aetiology included: 15 secondary to adhesions, 5 hernias, 4 crohns strictures and others. 28 patients had AXR on admission as well as CT with average time to CT of 13.4 hours from admission. A third received water soluble contrast, on average 32.9 hours after admission. A third patients required surgery, undertaken on average 60 hours from admission. The outcomes showed 25 recovering well and going home and a 30-day mortality of 13% (4/30). Seven patients received dietician input, two patients were reviewed by geriatricians before surgery and none post-operatively.  Conclusion From a previous review of our practice we improved in terms of instigating timely investigations and prompt decision to surgery. However, we need to clearly work towards a more holistic approach including dietician and geriatrician input within the complex post-operative management of these patients. 


2020 ◽  
Vol 8 (1) ◽  
pp. 170
Author(s):  
Pankaj Bargaje ◽  
Nitin Wasnik

Background: Aim of the study was to evaluate the causes of acute intestinal obstruction, modes of presentation and outcome of conservative and operative management in acute intestinal obstruction.Methods: The study was conducted in tertiary care academic hospital from November 2017 to October 2019. 60 Patients over 18 years of age who were diagnosed with acute intestinal obstruction were included in this study.Results: The result of present study showed that mean age distribution was 46±15.4 years. Incidence in males was more compared to females. Pain in abdomen was found in 54 (90%), vomiting in 38 (63%), distension of abdomen in 37 (61%) and constipation in 42 (70%) as patient’s chief complaint. Commonest cause was adhesions followed by obstructed inguinal hernia.Conclusions: From the result of present longitudinal study it can be concluded that conservative management can be tried in patients with previous history of abdominal operation and intestinal tuberculosis. Acute intestinal obstruction was more common in male than female. X ray abdomen in standing position and USG helps in ascertaining the site of intestinal obstruction.


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