scholarly journals ASSESSMENT AND MANAGEMENT OF INTESTINAL OBSTRUCTION IN PATIENTS ATTENDING TERTIARY CARE INSTITUTE

2021 ◽  
Vol 5 (11) ◽  
Author(s):  
Manish R. Malani ◽  
Sangita Santosh Nimbalkar
Keyword(s):  
Abdominal Pain ◽  
Inguinal Hernia ◽  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Tertiary Care ◽  
Diagnostic Techniques ◽  
Acute Intestinal Obstruction ◽  
Postoperative Adhesions ◽  
Operative Findings ◽  
Adhesive Obstruction

Background and Aim: Bowel obstruction is the most common intra-abdominal problem faced by general surgeons in their practice. Therefore better understanding of pathophysiology, improvement in diagnostic techniques, fluid and electrolyte correction, much potent antibiotics and knowledge of intensive care is required. present study was undertaken to study the management and post-operative complications of intestinal obstruction. Material and Methods: This is a prospective study of 97 cases presenting with symptoms and signs suggestive of acute intestinal obstruction. All patients are subjected to required preoperative biochemical investigations. Patients who showed reduction in abdominal distention and improvement in general condition especially in individuals with postoperative adhesions, a chance of conservative management was taken (by extending the supportive treatment) for further 12 to 24 hours; those who showed improvement by moving bowels, reduction in pain and tenderness was decided for conservative treatment, such individuals were excluded in this study. Results: The occurrence of acute intestinal obstruction was common in male in comparison with female. The commonest presenting symptom was abdominal pain (100%) followed by vomiting (92.7%), distention of abdomen (87.6%) and absolute constipation (53.6%). In this study, Adhesive obstruction (56.7%) was the commonest cause of acute intestinal obstruction. Release of adhesions and bands was done in 43 cases. Resection and end-to-end anastomosis was done in 25 cases, which included cases of intussusceptions, adhesions, stricture, ileocaecal growth, colonic growth. Conclusion: Most common etiological factor for intestinal obstruction is postoperative adhesions. Obstructed Inguinal Hernia is second most common cause of intestinal obstruction. Clinic radiological and operative findings put together can bring about the best and accurate diagnosis of intestinal obstruction. Key Words: Abdominal pain, Adhesions, Bands, Bowel obstruction, Inguinal Hernia,

scholarly journals STUDY OF SURGICAL MANAGEMENT OF INTESTINAL OBSTRUCTION FROM CENTRAL INDIA: A CROSS SECTIONAL STUDY

2021 ◽  
Vol 10 (3) ◽  
pp. 3070-3073
Author(s):  
Samadhan Patil
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Surgical Management ◽  
Central India ◽  
Signs And Symptoms ◽  
Tertiary Hospital ◽  
Acute Intestinal Obstruction ◽  
Postoperative Adhesions ◽  
Cross Sectional ◽  
Mortality And Morbidity

Intestinal obstruction is a common surgical emergency with high mortality and morbidity rates. About 15% of all emergency room visits for acute abdominal pain are due to intestinal obstruction. Acute intestinal obstruction may manifest in a variety of ways, from a relatively normal appearance with only minor abdominal pain and distension to a condition of hypovolemic or septic shock (or both) that necessitates an emergency procedure. In present study we aimed to evaluate surgical management of intestinal obstruction at our tertiary hospital. The current research included patients aged 21 to 80 who had an acute intestinal obstruction that was surgically treated. After initial resuscitation, patients with strong signs and symptoms of acute obstruction were treated with an appropriate surgical procedure. All of the information was recorded in a preformat and analysed using descriptive statistics. 144 patients had surgery for acute intestinal obstruction during the study period. 51 to 60 years old was the most common age group (26 %), followed by 41 to 50 years old (21 %). In a ratio of 2.8:1, male patients were more frequently affected than female patients. Previous abdominal surgery (56 %), diabetes (31 %), smoking (25 %), hypertension (24 %), and bronchial asthma/ COPD (15 %) were all found to be common comorbidities in this research. Postoperative adhesions (47 %), malignancy (15 %), obstructed hernia (11 %), and Koch's abdomen were the most common causes of intestinal obstruction in this report (8 %). Adhesiolysis (47 %), resection and anastomosis (22 %), diversion colostomy (13 %), and hernioplasty were the most common surgical procedures in this study (11 %). The most common post-operative complications were fever (15%) and wound infection (11%) respectively. The post-operative mortality rate was 13%. (9 patients). Complications such as septicaemia, peritonitis, and respiratory infection account for the majority of deaths. Intestinal obstruction is often caused by postoperative adhesions. Early operative procedures, in combination with clinical diagnosis and radiological findings, may enhance the outcome of acute intestinal obstruction.

scholarly journals Study of clinical spectrum and management of acute intestinal obstruction

2018 ◽  
Vol 5 (4) ◽  
pp. 1310
Author(s):  
N. K. Jaiswal ◽  
Sandeep Shekhar ◽  
Pushkar Ranade
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Signs And Symptoms ◽  
Large Bowel Obstruction ◽  
Acute Intestinal Obstruction ◽  
Medical College ◽  
Tertiary Centre

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.

scholarly journals Bowel obstruction due to the tightening of a loose bowel adhesion with uterus enlargement during pregnancy

2020 ◽  
Vol 5 (2) ◽  
pp. 109-112
Author(s):  
Ghazi Laamiri ◽  
◽  
Montassar Ghalleb ◽  
Nouha Ben Ammar ◽  
Slim Zribi ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Acute Intestinal Obstruction ◽  
Fetal Mortality ◽  
Past Medical History ◽  
Etiological Diagnosis ◽  
Postoperative Course ◽  
History Of

Introduction. Acute intestinal obstruction during pregnancy is a rare digestive surgical emergency. Generally, it is associated with significant maternal and fetal mortality. The diagnosis is difficult, often delaying the therapeutic management. It is reported an exceptional association of acute intestinal obstruction due to a band adhesion that is put into tension as the uterus enlarges. Case Report. A 35 years old Caucasian pregnant woman with a past medical history of appendectomy was examined and found with abdominal pain, severe vomiting, and bowel obstruction. The patient underwent surgery. Per operatively, the obstruction was caused by an adhesion put into tension by the enlargement of the uterus. The postoperative course was uneventful and the patient was discharged on day 2. Conclusions. The etiological diagnosis of acute intestinal obstruction during pregnancy is difficult. Surgery is the cornerstone of the treatment and the management varies depending on the intraoperative findings and the condition of the patient.

scholarly journals Acute intestinal obstruction due to appendicular tie syndrome: a rare case report

2019 ◽  
Vol 6 (9) ◽  
pp. 3446
Author(s):  
Akash Agrawal ◽  
Palak Vora
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Rare Case ◽  
Acute Intestinal Obstruction ◽  
Postoperative Adhesions ◽  
Surgical Emergencies ◽  
Common Causes ◽  
Rare Case Report

Acute intestinal obstruction is one of the most common surgical emergencies encountered by surgeons on daily bases. Most common causes for small bowel obstruction includes postoperative adhesions and hernia. One of the rarest cause of intestinal obstruction is appendicular band syndrome. Here we report a case of small bowel obstruction due to appendicular tie syndrome in a 70 years old male patient at GMERS hospital, Dharpur, Patan, Gujarat, India.

scholarly journals Abdominal tuberculosis: a surgical emergency

2017 ◽  
Vol 5 (9) ◽  
pp. 3847
Author(s):  
Rajandeep Singh Bali ◽  
Rahul Jain ◽  
Yawar Zahoor ◽  
Ankul Mittal
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Surgical Management ◽  
Surgical Intervention ◽  
Tertiary Care ◽  
Acute Intestinal Obstruction ◽  
Care Hospital ◽  
Number Of Patients ◽  
Management Protocol ◽  
Operative Findings

Background: To study and assess the clinico-pathologic profile, intra-operative findings, surgical intervention performed and outcome in terms of morbidity and mortality of the patients included in the study group.Methods: This study was carried out at Lok Nayak Hospital and Maulana Azad Medical College, New Delhi, a tertiary care hospital between November 2011 to March 2015. It was a retrospective study in which the records of the patients operated upon in the emergency department as peritonitis or acute intestinal obstruction and whose diagnosis was later confirmed as tuberculosis on histopathology were analysed with regards clinic-pathologic profile, intra-operative findings, surgical intervention performed and outcome in terms of morbidity and mortality.Results: The mean age of our study group was 28.7 years. 70% of our patients were found to be in the underweight category and 30% were in the normal category. Fourty three (56.6%) presented to the hospital with features suggestive of peritonitis and thirty-three (43.4) were suffering from acute intestinal obstruction. The commonest intra-operative finding encountered was ileal perforation followed by multiple small bowel perforations, solitary stricture of the small bowel with perforation, ileo-cecal mass, adhesions or bands, single or multiple strictures, stricture with impending small bowel perforation and jejunal perforation. The frequently performed surgical procedures were ilesotomy, resection and anastamosis of the involved bowel, primary repair of thr perforation, right hemicolectomy, adhesiolysis, stricturoplasty (done in case of single stricture, mostly), jejunostomy and peritoneal and omental biopsy.Conclusions: Tuberculosis is a very grave disease, studies with larger number of patients need to be conducted to standardise its surgical management as at present there is no standardised surgical management protocol.

scholarly journals Clinical study of acute intestinal obstruction in tertiary care centre

2017 ◽  
Vol 4 (9) ◽  
pp. 2903
Author(s):  
Vikas M. Daddenavar ◽  
Pramod Mirji ◽  
Ishwar Kalburgi
Keyword(s):  
Intestinal Obstruction ◽  
Tertiary Care ◽  
Age Distribution ◽  
Age Groups ◽  
Acute Intestinal Obstruction ◽  
Postoperative Adhesions ◽  
Tertiary Care Centre ◽  
X Ray ◽  
Main Complaint ◽  
Pain Abdomen

Background: Acute intestinal obstruction is one of common abdominal emergencies and is associated with significant morbidity and mortality, especially if it progresses to bowel ischemia. The aim of this study is 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 complication.Methods: Fifty consecutive patients of all age groups presenting with acute intestinal obstruction were admitted in SN Medical College HSK hospital were taken randomly and managed between February 2013 to February 2016. A detailed examination was done as per proforma after admission. Plain X-ray erect abdomen was done in all cases except inguinal hernias with obstruction.Results: Mean age distribution was 35.4 years. Incidence in male was more compared to female. Pain abdomen was found in 39 (78%), vomiting in 35 (70%), distension abdomen in 29 (58%) and constipation in 26 (52%) patients as main complaint. Commonest cause was postoperative adhesions. Mean duration of stay in hospital was between 1-5 weeks (average 2 weeks).Conclusions: All age groups were involved. More commonly found in males than females. Main complaint was pain abdomen followed by vomiting, distension and constipation. Plain X-ray abdomen and ultrasonography were important. Pathology ranged from simple bands to malignant obstruction. Postoperative adhesions were the commonest cause of obstruction. Earlier the presentation better the outcome was found.

scholarly journals Strangulated internal supravesical hernia associated with left inguinal hernia: A very rare case report of acute intestinal obstruction

2021 ◽  
pp. 102393
Author(s):  
El yamine othmane ◽  
Fatimazahra Bensardi ◽  
Abdessamad majd ◽  
El Bakouri Abdelilah ◽  
Bouali Mounir ◽  
...  
Keyword(s):  
Case Report ◽  
Inguinal Hernia ◽  
Intestinal Obstruction ◽  
Rare Case ◽  
Acute Intestinal Obstruction ◽  
Rare Case Report

A rare encounter of obstructed direct inguinal hernia

2019 ◽  
Vol 22 (2) ◽  
pp. 41-43
Author(s):  
Amit Kumar Singh ◽  
Nripesh Rajbhandari ◽  
Balaram Malla ◽  
Gakul Bhatta
Keyword(s):  
Emergency Department ◽  
Inguinal Hernia ◽  
Intestinal Obstruction ◽  
Intestinal Resection ◽  
Posterior Wall ◽  
Acute Intestinal Obstruction ◽  
University Hospital ◽  
Direct Inguinal Hernia ◽  
Direct Hernia ◽  
The Right

The direct inguinal hernia has a wider neck and thus usually doesn’t present as strangulation or incarceration in comparison to the indirect component. When direct inguinal hernias are untreated for a longer duration, they may get strangulated and incarcerated. Hence such long-standing direct hernias with features of intestinal obstruction and /or peritonism should be promptly seen and diagnosed to prevent massive and unwanted intestinal resection. We are reporting a case of 83-year-old male presented to Surgical Emergency Department of Dhulikhel Hospital, Kathmandu University hospital with complaints of swelling in the right inguinoscrotal region for 12 years and progressed to become irreducible and painful for 12 hours. Clinically he had an acute intestinal obstruction. Intra-operatively we found a direct hernia containing congested small bowel loops and toxic fluids. The toxic fluid was suctioned and after confirming viability, modified Bassini’s repair was done with reinforcement of the posterior wall. Even direct inguinal hernia of longer duration can cause acute or sub-acute intestinal obstruction with or without features of peritonism. This complication is more common in elderly patients.

scholarly journals TOURNIQUET APPENDIX: RARE ETIOLOGY OF ORGANIC ACUTE INTESTINAL OBSTRUCTION

2021 ◽  
Vol 9 (08) ◽  
pp. 834-836
Author(s):  
Bicane Ma. ◽  
◽  
Malaaynine Mf. ◽  
Rabbani K. ◽  
Louzi A. ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Paralytic Ileus ◽  
Rare Case ◽  
Acute Intestinal Obstruction ◽  
Ileal Loop ◽  
Surgical Emergency ◽  
Mechanical Bowel Obstruction

Acute appendicitis is the most common surgical emergency. A bowel obstruction due to the appendicitis is in most cases functional with a paralytic ileus mechanical bowel obstructions are rare or exceptional. We describe a rare case of a mechanical bowel obstruction due to a strangulation of the last ileal loop by the appendix.

scholarly journals Etiologic Spectrum of Intestinal Obstruction in Ningxia District: A Retrospective Analysis of 4908 Cases in a 10-Year Period

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Wei Jiang ◽  
Wenyan Li ◽  
Qian Hao ◽  
Yuping Yao ◽  
Yajun Li ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Clinical Manifestations ◽  
Therapeutic Interventions ◽  
Malignant Bowel Obstruction ◽  
Increasing Trend ◽  
Adhesive Intestinal Obstruction ◽  
Adhesive Obstruction ◽  
Medical University ◽  
Overall Mortality

Background. Economic disparity contributes to the variation of intestinal obstruction (IO) etiologic spectrum. Clarifying the etiology distribution in local regions can help to unravel IO and promote early diagnosis, henceforth making sure standardized therapeutic interventions. Methods. Medical data of 4908 inpatients diagnosed with IO admitted to the General Hospital of Ningxia Medical University between January 2004 and December 2013 were recruited and analyzed retrospectively. The associated profiles included demographic features, clinical manifestations, and previous therapeutic operations. Results. 4908 cases of intestinal obstruction were identified during the period of study. It denoted that the hospitalization rate of IO has maintained upward momentum; the top four causes of IO were adhesion, tumor, intussusception, and hernias. These covered up nearly 80% of the total constitution. Among them, adhesive intestinal obstruction accounted for 45.17%, malignant bowel obstruction for 21.09%, intussusception for 8.72%, and hernia for 4.73%; abdominal surgery constituted for the majority (78.62%) of adhesive obstruction. The followed up analysis also found that appendectomy accounted for the biggest percentage, 28% of operation cases. Malignant bowel obstruction can have a rate of 96.43% in 1035 cases led by tumor lesions. Of which, the primary intestinal malignant tumor accounted for 68.64% and metastatic tumors for 31.36%. Nearly 50% occurred in the large intestine. The overall mortality of all 4908 cases was 4.7%. Conclusion. The hospitalizations of IO delineated an increasing trend. Adhesion was the main etiology in IO. The odds of malignant bowel obstruction was increasing in the proportion of IO. There were some differences towards the etiologic spectrum compared with western countries.

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