Magnitude and Determinants of Treatment Outcome Among Surgically Treated Patients with Intestinal Obstruction at Public Hospitals of Wolayita Zone, Southern Ethiopia: Across Sectional Study

Abstract Background: Procedures to treat intestinal obstruction range from minimally invasive laparoscopic surgery to more complicated open surgical procedures. It may end with high morbidity and mortality because of different reasons. It is very important to know about the determinants of favorable outcome of surgical management for intestinal obstruction however, little is known about this problem at public hospitals of Southern Ethiopia. Methods: Facility based cross sectional study was conducted. A total of 230 medical records which fulfill the inclusion criteria were used for this study. Variables with p value of less than 0.25 in the bivariate analysis were entered in multivariable logistic regression to control confounding. Finally, odds ratio with 95% confidence interval was used to identify variables which were significantly associated with dependent variable. Results: According to this study the magnitude of favorable surgical management outcome of intestinal obstruction was 177(77.0%) [95% CI, 71.4, 82.4]. Having small bowel obstruction (AOR=2.49) [95% CI 1.91, 5.12], having simple bowel obstruction (AOR=4.32) [95% CI, 2.00, 9.35], early presentation of patients (AOR=4.44) [95% CI, 1.99, 9.92] and intraoperative procedure other than resection and anastomosis was performed (AOR=0.45) [95% CI, .21, .96] were significantly associated with favorable outcome among surgically treated patients.Conclusion: The overall magnitude of favorable surgical management outcome of intestinal obstruction was moderate compared to other study. Having small bowel obstruction, having simple bowel obstruction, other procedure other than resection and anastomosis done, and early presentation of patients were significant predictors. Physicians should diagnose intestinal obstruction early and appropriate interventions should be taken on time before the complication happened. On time consultation and decision at the hospital setting is also recommended.

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Impact of Race on the Surgical Management of Adhesive Small Bowel Obstruction

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2017.11.006 ◽

2018 ◽

Vol 226 (6) ◽

pp. 968-976.e1 ◽

Cited By ~ 3

Author(s):

Alexander S. Chiu ◽

Raymond A. Jean ◽

Kimberly A. Davis ◽

Kevin Y. Pei

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Surgical Management ◽

Bowel Obstruction ◽

Adhesive Small Bowel Obstruction

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META-ANALYSIS ON ETIOPATHOGENESIS OF SMALL BOWEL OBSTRUCTION IN THE DEPARTMENT OF GEN. SURGERY P.M.C.H. & K.M.C.H., BIHAR

10.36106/ijsr/6700138 ◽

2021 ◽

pp. 1-3

Author(s):

Abhishek Chaudhary ◽

Kanchan Sone Lal Baitha ◽

Yasir Tajdar

Keyword(s):

Small Intestine ◽

Small Bowel ◽

Abdominal Surgery ◽

Intestinal Obstruction ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Meta Analysis ◽

Ileocaecal Valve ◽

Time Period ◽

Ligament Of Treitz

Background:The small intestine is the longest and convoluted portion in the digestive tract. It starts from pylorus and ends at ileocaecal valve. The small bowel consists of three parts measuring about 5 to 6 meters. The rst 25cm is the duodenum. Out of the rest part of small gut, jejunum th th. constitute the proximal 2/5 and ileum distal 3/5 The jejunum and ileum extend from the peritoneal fold that supports the duodeno-jejunal junction (Ligament of Treitz) down to ileocaecal valve. Material and Methods:All the patients admitted to PMCH, Patna and KMC, Katihar as intestinal obstruction was included for the study. The time period of study was from October 2014 to November 2016 in PMCH and December 2016 to January 2019 in KMC, Katihar. Out of all Intestinal obstruction 59 cases only of adult small gut obstruction were recorded for comparison and conclusive study.Conclusion: Small bowel obstruction remains a frequently encountered problem in abdominal surgery. Although modern day surgical management continues to focus appropriately on avoiding delayed operation, whatever surgery is indicated, not every patient is always best served by immediate operation

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SMALL BOWEL OBSTRUCTION SECONDARY TO OBTURATOR HERNIA: A PRE-OPERATIVE DIAGNOSIS AT COMPUTED TOMOGRAPHY

Journal of Clinical and Health Sciences ◽

10.24191/jchs.v6i1.8868 ◽

2021 ◽

Vol 6 (1) ◽

pp. 46-49

Author(s):

Marlina Tanty Ramli ◽

Mohd Shukry Mohd Khalid ◽

Kartini Rahmat

Keyword(s):

Computed Tomography ◽

Small Bowel ◽

Elderly Patients ◽

Intestinal Obstruction ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Surgical Intervention ◽

Obturator Hernia ◽

Uneventful Recovery ◽

Presenting Symptoms

Obturator hernia is rare, but it must be considered in elderly patients who present with small bowel obstruction. The diagnosis is challenging unless there is a high index of suspicion as the presenting symptoms and signs are usually non-specific. Presence of positive Howship-Romberg sign is considered pathognomonic. Early diagnosis and rapid surgical intervention will reduce the high morbidity and mortality associated with undiagnosed obturator hernia. We report a case of a 93-year-old female patient who was admitted to our surgical department with symptoms of intestinal obstruction of 3-days duration. Howship-Romberg sign was negative. Computed tomography (CT) demonstrated the presence of left obturator hernia with proximal small bowel obstruction and no sign of strangulation. The patient had emergency laparotomy post-CT where the incarcerated bowel loop was released and the obstructed bowel was decompressed without any complication. The hernial defect was close with a mesh and the patient had an uneventful recovery post-surgery. In this case, we highlight that diagnosis of obturator hernia must always be considered in elderly patients who present with intestinal obstruction. Urgent CT could establish a rapid pre-operative diagnosis and aids inappropriate surgical intervention planning which is crucial in optimising the outcome.

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Small Bowel Obstruction by Wireless Enteroscopic Capsule and Unrecognized Intestinal Stricture

The American Surgeon ◽

10.1177/000313480607201213 ◽

2006 ◽

Vol 72 (12) ◽

pp. 1216-1217

Author(s):

Hadi Najafian ◽

Camille Eyvazzadeh

Keyword(s):

Small Bowel ◽

Physical Examination ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Unusual Case ◽

Bowel Resection ◽

Anastomotic Stricture ◽

History Of ◽

Resection And Anastomosis

The wireless enteroscopy capsule (WEC) was approved for noninvasive visualization of small bowel. We report an unusual case of a previously healthy man with history of bowel resection and anastomosis who developed small bowel obstruction after ingestion of a WCE. At operation, an anastomotic stricture site was noted and the WEC was proximal to this stricture, causing obstruction. This case emphasizes the importance of a good history and physical examination, as well as vigilant follow-up and retrieval of WEC.

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The role of the laparoscopic approach in the surgical management of acute adhesive small bowel obstruction

BMC Surgery ◽

10.1186/s12893-019-0504-x ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 10

Author(s):

Enric Sebastian-Valverde ◽

Ignasi Poves ◽

Estela Membrilla-Fernández ◽

María José Pons-Fragero ◽

Luís Grande

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Surgical Management ◽

Bowel Obstruction ◽

Laparoscopic Approach ◽

Adhesive Small Bowel Obstruction

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Acute Small-Bowel Obstruction From Intestinal Anisakiasis After the Ingestion of Raw Clams; Documenting a New Method of Marine-to-Human Parasitic Transmission

Open Forum Infectious Diseases ◽

10.1093/ofid/ofu087 ◽

2014 ◽

Vol 1 (2) ◽

Cited By ~ 6

Author(s):

Ehyal Shweiki ◽

David W. Rittenhouse ◽

Joana E. Ochoa ◽

Viren P. Punja ◽

Muhammad H. Zubair ◽

...

Keyword(s):

Small Bowel ◽

Intestinal Obstruction ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Parasitic Infection ◽

Human Infection ◽

New Method ◽

Acute Small Bowel Obstruction ◽

Intestinal Anisakiasis

Enteric anisakiasis is a known parasitic infection. To date, human infection has been reported as resulting from the inadvertent ingestion of the anisakis larvae when eating raw/undercooked fish, squid, or eel. We present a first reported case of intestinal obstruction caused by anisakiasis, after the ingestion of raw clams.

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Causes, evaluation and surgical management of mechanical small bowel obstruction

International Surgery Journal ◽

10.18203/2349-2902.isj20150917 ◽

2015 ◽

pp. 492-495

Author(s):

Md. Ahmad ◽

Md. Shadab ◽

Saif Omar ◽

Amjad Mallik ◽

Md. Ansari

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Surgical Management ◽

Bowel Obstruction

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Evaluation of the role of oral gastrografin in management of simple adhesive small bowel obstruction in children

International Surgery Journal ◽

10.18203/2349-2902.isj20190391 ◽

2019 ◽

Vol 6 (2) ◽

pp. 498

Author(s):

Almoutaz A. Eltayeb ◽

Nagla H. Abufaddan

Keyword(s):

Small Bowel ◽

Intestinal Obstruction ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Randomized Study ◽

Total Duration ◽

Oral Feeding ◽

Adhesive Small Bowel Obstruction ◽

Number Of Patients

Background: The risk of post-operative adhesive small intestinal obstruction is highest during the first post-operative year. Bowel injury during adhesiolysis increases the post-operative morbidity. Consequently, the conservative management of small bowel obstruction has considerable interest. The aim of this study was to evaluate the therapeutic role of gastrografin in the management of small bowel obstruction.Methods: All patients with simple adhesive small bowel obstruction will be included and treated conservatively for 48hours unless there was evidence of strangulation. After the first 48hours all the patients were given oral gastrografin unless improved or signs of strangulation arise. The evaluating parameters are the success rate, time to start full oral feeding and total duration of hospital stay.Results: Twenty-five cases were included in which two of them developed clinical evidence of strangulation during the first 48hours and were explored. Three cases improved on the conservative treatment. The remaining twenty cases were given oral gastrografin. Fourteen cases out of twenty showed the contrast dye in their large bowel by 24hours. Those 14 cases tolerated full oral feeding earlier and had shorter hospital stay than the remaining 6 cases that declared treatment failure and underwent surgical exploration.Conclusions: The use of gastrografin as a preliminary step of non-surgical treatment of simple adhesive intestinal obstruction may be helpful. However, further randomized study on a large number of patients was needed.

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