STUDY OF INTESTINAL OBSTRUCTION WITH CLINICAL EVALUATION

Abstract

Introduction: Intestinal obstruction is acute problem presenting in a common surgical emergency and a frequently encountered in abdominal surgery. Intestinal obstruction is a common surgical emergency problem worldwide. Intra-abdominal problems are one of the most common as Intestinal Obstruction by general surgeons in their practice. Intestinal obstruction is defined as obstruction in forward propulsion of contents of the intestine either due to active or inactive or pseudo-obstruction. It is predisposed by varying underlying abnormality diseases that are difficult to define pre-operatively. About 12% to 16% of acute abdominal emergencies may be contributed to intestinal obstruction. With multiple etiologies for intestinal obstruction of either the small or large bowel which become to be a major cause of morbidity and mortality. For intestinal obstruction there are various mode of presentation underlying various cause in each age group. In ancients period mortality and morbidity was very high. Most of the mortality occurs in elderly age with late treatment and who are having associated pre-existing diseases like, diabetes mellitus, COPD and cardiac diseases.

Aim: The main aim of this study is to study the Intestinal obstruction with different modes of presentations.

Material and methods: In this study total 70 patients were included having intestinal obstruction with various problems. A clinical study of intestinal obstruction were selected has to come across this surgical emergency and treatment and skillful management in surgery department of our hospital. From all the patients complete clinical history was collected and also physical examinations were done. All patients’ data with the operative and discharge record were correlated with the case notes wherever necessary.  Patients who had hernia with recent onset of irreducibility, pain, vomiting and constipation were included in this study. Surgery stabilization of patients with shock, correction of electrolyte imbalance and nasogastric decompression was done with prior. Appropriate surgical procedure was carried out.

Result: The study was done in all age groups with a mean age of 35 years. Maximum presenting symptoms was abdomen pain (67.1%) followed by vomiting (51.4%), Tenderness (61.4%), distension of abdomen (40%) and constipation (37.1%), most of patients with overlapping of symptoms. Etiology of intestinal obstruction shows 58 cases (82.9%) as shown in Table below. Adhesions is consider for majority of obstruction followed by Obstructed hernias (21.4%), Small bowel volvulus (11.4%) and Bands (8.6%).

Conclusion: Intestinal obstruction is more common in males compared to females. Intestinal obstruction differs in different levels with mode of presentation. Adhesions accounted for majority of intestinal obstruction.  Intestinal obstruction was found more common in children than other age groups. Malignancies are also common causes of intestinal obstruction. The clinical examination stressed upon vital signs and abdominal examination and Routine necessary investigations were carried out. Hence early recognition and timely intervention is important to prevent the intestinal obstruction.

Keywords: Intestinal obstruction, adhesions, hernia, intraperitoneal malignancy.