Study of Emergency Intestinal Resection and Anastomosis in Adults

Title: Study of Emergency Intestinal Resection and Anastomosis in Adults

Authors: Dr Aarti Mitra, Dr Unmed Chandak, Dr Ninad Sawant, Dr Rachit Mitra

DOI: https://dx.doi.org/10.18535/jmscr/v4i10.118

Abstract

Aims and Objectives: (1) To study the emergency intestinal resection and anastomosis. (2) To study various intestinal pathologies for which emergency intestinal resection and anastomosis was performed. (3)To study various complications associated with emergency intestinal resection and anastomosis (4) To study the morbidity and mortality associated with emergency intestinal resection and anastomosis (5) To study various risk factors responsible for failure of emergency intestinal resection and anastomosis

Study Design: It was prospective study done over a period of 2 years conducted at a tertiary care hospital. All patients admitted to any surgical unit in our institute aged between 18-80 years in whom emergency intestinal resection and anastomosis was performed were enrolled in this study.

Materials and Methods: The study was approved by the Institutional ethical committee. The patients admitted in any surgical unit and fulfilling the criteria were enrolled in the study. After detailed history and detailed investigations the etiopathology, risk factors, complications, morbidity and mortaility patterns were studied in the patients who have undergone emergency resection and anastomosis. Failure of anastomosis along with risk factors were also studied.

Results: Amongst the studied cases 62 (67.4% ) were females and 30 (32.6%) were males with an overall mean age of Mean age of 41.34 years. The minimum duration of complaints was 2 days while maximum duration of complaints was 15 days with a mean duration being 4.27 days. Most of the patients were anaemic and only one patient had Hb of more than 12 gm%.22 (23.91%) patients had Sr albumin levels less than 3.5 gm %. Most common co-morbid conditions seen in patients was diabetes and hypertension which was seen in 7 (7.6 %) patients. 72 patients had no co-morbidities. 44 (47.82%) patient had evidence of some contamination either in the form of infected free fluid, pus , focal matter or combination of above. 19 (20.65%) patients required some kind of inotropic support either before, during or after surgery. Out of the studied cases 48 (52.17%) patients required blood or blood product transfusion. The most common pathologies for which emergency resection and anastomosis was done were stricture in small bowel and malignancy in large bowel. Most common anastomosis done was ileo-ileal which was done in 42 patients. Ileo-descending and jejuno-ascending were done least frequently ie in 1 patient each. Drainage of peritoneal cavity was done in 78 (84.78%) patients. The most common complications seen in the patients were wound infection and fever which were seen in 58 (63.04%) and 42 (45.65%) patients respectively. The mean duration of hospital stay was found to be 12.70 days and death occurred in 11(11.92%) patients.

Conclusion: This study summarizes the main pathologies, risk factors, complications, morbidity and mortality rates and outcome in patients who have undergone emergency resection and anastomosis at a tertiary care hospital. In order to reduce complications it is important to know these risk factors and complication so that strategies to prevent, treat or reduce these complications can be made.

Keywords: Emergency resection and anastomosis, risk factors, complications.

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Corresponding Author

Dr Ninad Sawant

Resident, Department of Surgery,

Government Medical College, Nagpur India