Aetiological factors in mechanical intestinal obstruction (original) (raw)

A Prospective Study on Clinico-Pathology, Management and Outcome of Acute Mechanical Bowel Obstruction in a Tertiary Care Centre in Jharkhand

Acute mechanical bowel obstruction is a common surgical emergency and a frequently encountered problem in abdominal surgery. It constitutes a major cause of morbidity and financial expenditure in hospitals around the world and a significant cause of admissions to emergency surgical departments. This was a prospective observational study of patients admitted to the Department of General Surgery, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India with a diagnosis of acute mechanical bowel obstruction between April 2015 and October 2016. 157 patients included in the study. Mean age of the patients was 58.8 years. Constipation (86.0%) and absence of passage of flatus (77.1%) were the most common presenting symptoms, and abdominal distension (89.2%) was the most frequent physical finding on clinical examination. In the total study group of patients with small or large bowel obstruction-adhesions, incarcerated hernias, and malignancies constituted the most frequent causes (64.8%, 14.8%, and 13.4%, respectively). 84 patients (53.5%) of the total study group were treated conservatively. 7 patients died (mortality-4.5%); and mostly died due to multiple organ failure.

An Analytical Study of Causes, Clinical Presentation and Prognosis of Intestinal Obstruction in Tertiary Care Hospital

IOSR Journals , 2019

Obstructed hernias are the common cause of intestinal obstruction in our study, due to lack of awareness among rural population, followed by adhesions and bands, with pain abdomen as the most common presenting symptom. Majority of patients with intestinal obstruction needs surgical relief of obstruction Clinical, radiological and operative findings put together can bring about the best and accurate diagnosis of intestinal obstruction. Plain x ray is the single most important diagnostic tool for intestinal obstruction. Early recognition and aggressive treatment is needed to prevent gangrenous changes. Prognosis was poor in elderly patients. The most common cause of morbidity and mortality was septicemia, anastomotic leak, wound infection and pulmonary infection. Patients who presented with strangulation had poor outcome. In our study the most common cause of death was septicemia.

Intestinal obstruction in adults at the Aga Khan University Hospital

JOURNAL OF PAKISTAN MEDICAL ASSOCIATION, 1994

During the period January, 1987 to June, 1991, 208 adults with mechanical bowel obstruction were managed at The Aga Khan University Hospital (AKUH). Post-operative adhesions accounted for 34% of the cases and were the most frequent cause of intestinal obstruction. External hemia (16%), malignancy (13.5%) and tuberculous stricture (10%) were the next most frequent causes. The predominance of adhesive intestinal obstruction at AKUH shows a trend towards a Western disease pattern. Socioeconomic status was a significant determinant of the cause of obstruction. The proportion of self paying to welfare patients was significantly lower in tuberculous obstruction as compared with adhesive or malignant obstruction and in obstruction caused by hernia as compared with that due to malignant disease (P < 0.05). The present study demonstrates the synchronal occurrence of old and new diseases in a population and points towards the epidemiological transition which is affecting urban areas in the...

Pattern, Management and Outcome of Acute Intestinal Obstruction at Chitwan Medical College Teaching Hospital

Journal of Chitwan Medical College

Background: Acute intestinal obstruction is one of the commonly encountered emergencies in surgical practice. Gynecological surgery, especially adnexal surgery and hysterectomy has a higher incidence of bowel obstruction as compared to bowel surgery. Conservative management can be done in patients with post-operative adhesive bowel obstruction if there is no evidence of ischemia, bowel necrosis, or perforation. Therefore, a correct diagnosis is essential for appropriate management. We conducted a study to evaluate the etiology, clinical presentation as well as management and outcome of patients presenting with Acute intestinal obstruction at our center. Methods: This was a retrospective study of all the patients with a diagnosis of Acute intestinal obstruction from January 2015 to December 2019. The diagnosis of Acute intestinal obstruction was made by a combination of clinical and radiological parameters. The data were analyzed using Statistical Package for Social Sciences (SPSS) f...

Current Spectrum of Intestinal Obstruction in a Teaching Hospital

TAJ: Journal of Teachers Association

Intestinal Obstruction is a common surgical emergency and constitutes a major cause of morbidity and financial expenditure in hospitals around the world. This study aimed to provide the current spectrum of intestinal obstruction in a tertiary care hospital with a special view to identify any change in the aetiologic pattern. This prospective observational study was carried out in all four surgical units of Rajshahi Medical College Hospital from September 2010 to August 2011. The study included 250 adult patients with clinical and radiological evidence of complete intestinal obstruction. Out of 250 consecutive patients ranging between (13-90) years with a male to female ratio of 2.1:1, the maximum cases were within (31-40) years and (51-60) years of age group. In this study 175 cases (70%) were presented with small bowel and 75 cases (30%) with large bowel obstruction. The main causes of obstructions were bands and adhesions (44%) followed by volvulus (18%), external hernias (16%), n...

Management and post operative complication of acute intestinal obstruction

International Surgery Journal, 2020

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 present...

A Study of Prevalence and Pattern of Acute Intestinal Obstruction in a Tertiary Care Centre

Background: Intestinal obstruction is a common cause of acute abdomen worldwide. It is the leading cause of morbidity and mortality from all causes of acute abdomen 17. In spite of tremendous advances in medicine, bowel obstruction still remains a question of good clinical acumen. Bowel obstruction poses great dilemma in both diagnosis and management. The pattern of intestinal obstruction varies between communities and in different age groups 1. Materials and Methods: This retrospective study is conducted on the cases presented with pain and distension of abdomen with constipation/obstipation to K R hospital for a period of 1year from June 2020 to May 2021. This study includes patients with intestinal obstruction managed with surgical intervention. Results: Majority of the intestinal obstruction in our scenario are caused by postoperative adhesions followed by malignancies. Diagnosis of bowel malignancies at early stage itself can reduce the complications and ensure a better prognosis. Obstructed hernia is the 3 rd most common cause of intestinal obstruction according to this study. Although its incidence is decreasing yet patients need to be educated about the complications of hernia and thus advised to get surgical opinion at early stages itself. Conclusion: Majority of the intestinal obstruction in our scenario are caused by postoperative adhesions followed by malignancies. So better operative care and techniques need to be employed in primary laparotomy so as to reduce the chances for development of post-operative adhesions. Obstructed hernia is the most 3 rd most common cause of intestinal obstruction according to this study.

A clinical study on the surgical management of intestinal obstruction

International Surgery Journal, 2019

Background: Intestinal obstruction remains one of the common emergencies encountered by general surgeons all over the world. Acute intestinal obstruction occurs when there is a disruption in the frontward flow of intestinal contents.Methods: This study is a prospective study conducted in Dr. D Y Patil Medical College and Hospital, Pimpri, Pune. Patients coming to the hospital with signs and symptoms suggestive of intestinal obstruction and willing for surgical management in our hospital were included after taking written and informed consent.Results: In our study, pain abdomen and abdominal distension was the most common presenting complaints in 90% and 92% of the patients respectively. On palpation, 96% of the patients had abdominal tenderness, 72% of the patients had guarding and 12% of the patients had rigidity. On auscultation, all patients had some abnormality with regard to bowel sounds. It has been noted that intestinal strictures and abdominal adhesions were amongst the most...