scholarly journals THE PATTERN OF ACUTE INTESTINAL OBSTRUCTION: A HOSPITAL BASED STUDY

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.


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.


2020 ◽  
Vol 7 (12) ◽  
pp. 4139
Author(s):  
Y. Anantha Lakshmi ◽  
K. V. Narasimha Reddy

Background: The intestinal obstruction is a common potentially risky surgical emergency in all age group globally. This is responsible for 12% to 15% of surgical admission due to acute abdomen. Obstruction to gastrointestinal tract can occur at all labels but it is small intestine which more commonly involved. To improve the outcome early diagnosis and management is essential. Present study has been designed to study the epidemiology, demography and clinical presentation of acute intestinal obstruction and to study the complications and outcome of surgical management of acute intestinal obstruction.Methods: In present study patients admitted with diagnosis of acute intestinal obstruction during study period were enrolled for this study as per inclusion and exclusion criteria. As per that 126 patients were enrolled for this study. Case record of all patients were closely reviewed and analysed thoroughly.Results: The mean age of the patients was 54.64±12.93 years. The acute intestinal obstruction was more common in 41 to 60 years of age group that is (44.45%). Regarding etiology of acute intestinal obstruction 44.45% patient adhesion was the etiology of obstruction. Resection of adhesion was most common procedure done for removal of obstruction (42.85%).Conclusions: Adhesion was most common etiology and pain abdomen and tachycardia was common presentation. Regarding management of obstruction resection of adhesion was most common procedure done for removal of obstruction. Infection of wound was common complication.


Author(s):  
А.А. Коваленко ◽  
В.К. Хугаева

Высокая смертность при хирургическом лечении острой кишечной непроходимости (ОКН) определила поиск новых методов сопутствующей терапии. Обнаруженная ранее высокая эффективность опиоидных пептидов в стимулировании лимфотока в микрососудах брыжейки тонкой кишки у крыс, восстановлении нарушенной микроциркуляцию и снижении смертности при ряде заболеваний, определила цель данного исследования: изучить роль фармакологической стимуляции лимфотока в динамике ОКН. В работе использовали методы: биомикроскопия, лазерная допплеровская флоуметрия брыжейки и стенки тонкой кишки крысы, регистрация сократительной активности лимфатических микрососудов ЛМ методом фотометрии, морфометрия микрососудов, видео- и фотосъемка. Полученные результаты предполагают наличие адаптационной роли у активатора микролимфоциркуляции (опиоидного пептида-171 прямого действия) в комплексном хирургическом лечении ОКН. Однократное орошение пептидом межкишечного анастомоза (после удаления) и поврежденного лигатурой фрагмента кишки (перед зашиванием операционной раны) увеличивало выживаемость животных с ОКН на 23%. У всех выживших животных отмечено восстановление: проходимости кишки, микроциркуляции в кровеносных и лимфатических микрососудах, а также структуры стенки кишки. High mortality in the surgical treatment of acute intestinal obstruction (AIO) has warranted the search for new methods of concomitant therapy. Opioid peptides have proved highly effective in stimulating the lymphatic flow in rat small intestinal mesenteric microvessels, restoring the impaired microcirculation, and reducing mortality in many diseases. This had determined this study objective: to investigate the role of lymphatic stimulation in the dynamics of AIO. The study used methods of biomicroscopy, laser Doppler flowmetry, and histological examination of the mesentery and the small intestinal wall in rats; recording the contractile activity of lymphatic microvessels using photometry; microvessel morphometry; video and photography. The study results suggested an adaptive role of the lymphatic microcirculation activator (direct-action opioid-171) in the complex surgical treatment of AIO. A one-time peptide irrigation of the intestinal anastomosis (after removal) and the intestinal injuried by the ligature (before the surgical wound was sutured) increased the survival of animals with AIO by 23%. In all surviving animals, recovery of the intestinal patency, blood and lymphatic microcirculation, and the intestinal wall structure was observed.


2021 ◽  
Vol 9 (1) ◽  
pp. 81
Author(s):  
Pauly T. Joseph ◽  
Rajiv Sajan Thomas ◽  
Sutharjivel V.

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.  


F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1037
Author(s):  
Mahnaz Hakeem ◽  
Heeramani Lohana ◽  
Sarwat Urooj ◽  
Sheraz Ahmed

Bezoars are an undigested mass causing an intraluminal obstruction in children.  Pharmacobezoars are formed from medicines or their vehicle, considered as a less frequent type observed in children. Our objective is to report a relatively rare entity as a potential cause of intestinal obstruction in children.  Here we report a case of 13-year-old girl with a history of herbal medicine intake who presented with persistent vomiting and abdominal distension. She was diagnosed with acute intestinal obstruction and managed conservatively without any complications. The patient became stable within two days so was discharged home. We found that ineffective history could lead to a delay in diagnosis and management. Clinicians should have a high index of suspicion for pica and psychiatric disorders, especially in adolescent children.


2020 ◽  
Vol 3 (1) ◽  
pp. 120-123
Author(s):  
Anantha Kumar Nateson ◽  
Suresh Nayak Basavanayak ◽  
Sudarsan Srikanth

Background: Bowel gangrene is a major abdominal catastrophe associated with high mortality rate. Intestinal obstruction accounts for 20%   of all surgical emergencies around the world. The present study aims to estimate the LDH levels in patients with acute intestinal obstruction and correlate with bowel viability. Subjects and Methods: In this study, the estimation of serum LDH was conducted in 45 cases of acute intestinal obstruction who were admitted in surgical wards. After fulfilling the inclusion and exclusion criteria the study subjects were recruited. All the cases were thoroughly examined. Time of presentation and onset of symptoms were noted. Under aseptic conditions, 3 ml venous blood samples were collected from the study subjects, centrifuged at 3000 rpm and separated serum sample was used for the estimation of lactate dehydrogenase (LDH) and the estimated value of serum LDH is compared with the viability of the bowel intra operatively. Results: The total number of patients presented with obstruction is 45 out of which 25 were found to have elevated LDH which is about 55.56%. Out of 25 patients presented with elevated LDH, 20 patients found to have gangrenous bowel. 60% presented with abdominal pain and 40% had irreducible swelling. Most commonly associated symptoms are vomiting (84%) followed by abdominal distension (40%), obstipation (36%), pyrexia (24%), blood in stools (8%) and diarrhoea (4%). Per rectal examination showed 76% had normal faecal staining, 12% blood stained faeces and 8% empty. Complications observed were anastomotic leak 8%, wound infection 16%, wound gaping 8%, burst abdomen 8%. Conclusion: The present study results indicate that ischemic changes in any part of the bowel can cause elevation in the serum levels of LDH and a higher value of >1000 IU/L strongly indicates an underlying gangrenous change. It is a less invasive, cost effective and easily available diagnostic tool to diagnose bowel ischemia/gangrene. Hence it is more useful in centres where the diagnostic facilities are limited.


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.


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