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Category: Volume 07 Issue 10 October 2019
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Title: A Hospital based study on surgical management of Acute Intestinal Obstruction

Authors: Dr Arun Katari, Dr CH.Maruthi

 DOI: https://dx.doi.org/10.18535/jmscr/v7i10.152

Abstract

Acute intestinal obstruction is a medical emergency because of its potential for bowel ischemia leading to perforation and peritonitis. Early recognition and appropriate treatments are thus required for better outcomes. We in the current study tried to evaluate the epidemiology and outcome of surgical management of acute intestinal obstruction in our tertiary care teaching hospital. 

Methods: This prospective cross sectional study was done in the Department of General Surgery, Prathima Institute of Medical Sciences, Nagunoor, Karimnagar. A total of n=50 cases were identified and treated during the period of the study. The complete medical history and thorough clinical examination of each patient were done. A detailed recording of all symptoms such as colicky abdominal pain, nausea, vomiting, abdominal distention, absence of bowel movement and inability to pass flatus were recorded. After the examination the patients were subjected to radiological investigations which included plain upright abdominal radiograph, ultrasonography was done in patients who were not suitable for CT examination.

Results: The most common presenting symptom in the patients was abdominal pain in 100% of the patients followed by constipation in n=84% of patients. The most common signs were Tachycardia in n=78%, abdominal tenderness in n=64%, and rigidity in n=48%. Hernioplasty was performed in n=20(40%) of the patients and hernioplasty with adhesiolysis in n=7(14%) of the patients. Untwisting the volvulus was done in n=3(6%), Adhesiolysis was performed in n=6(12%) of patients. Resection and anastomosis were performed in n=10 (20%) of the patients. Ileotransverse anastomosis was done in n=4(8%) of the patients.

Conclusion: Acute intestinal obstruction is a life-threatening surgical emergency and requires prompt diagnosis and effective therapy. The most common etiological factor for acute intestinal obstruction in our study was hernia followed by adhesions. Best outcomes are for patients with early diagnosis and skillful management within a reasonable time frame. Poor prognosis is generally related to older patients and late presentation to the hospital.

Keywords: Acute Intestinal obstruction, surgical management, Hospital based study.

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Corresponding Author

Dr CH. Maruthi

Flat number 217, Royal Pavilion Apartments, Beside RBI officers quarters, Ameerpet, Hyderabad-500016 Telangana State, India