Large Bowel Obstruction: Management and Outcome in Omdurman Teaching Hospital
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2015, Vol 3, Issue 2
Abstract
Large bowel obstruction (LBO) constitutes 15% of intestinal obstruction. The most common causes are colorectal cancer (CRC) and sigmoid volvulus (SV). CRC in Sudan was found in young age group. Clinical features are almost the same with symptoms of SV tend to occur in recurrent episodes. Surgical procedures for colonic obstruction include multi stage procedures and single stage procedureusing primary anastomosis with or without colonic lavage. The objective was to study the management and outcome of LBO in Omdurman teaching hospital. This is a prospective observational study conducted at Omdurman teaching hospital including all patients presented with LBO from Jun. 2013-Sep. 2014. Paediatric patients were excluded. Data collected through a preformed questionnaire and analyzed using computer programme package for social sciences (SPSS) version 20. LBO accounted for 21.6% of intestinal obstruction. Volvulus formed 35.6% of cases and malignancy 64.4%. The mean age was 51.73±20.18 years. There is overall male preponderance with M: F ratio of 2.8:1. Gangrenous bowel was found in 8.9% of patients and all were cases of volvulus. Obstructing CRC was commonest in the left colon with the highest percent at the rectosigmoid junction (33.3%). Hartmann’s procedure (HP) and primary anastomosis were done in 57.8% and 13.3% of patients respectively. The mortality of HP was 15.4% and of the primary anastomosis was 50%. In conclusion; the pattern of LBO in Sudan is changing over years towards CRC. There is overall male preponderance. CRC tends to affect younger age groups. HP is the commonest procedure with mortality rate lower than primary anastomosis. Keywords: Colorectal cancer, Large bowel obstruction, Sigmoid volvulus.
Authors and Affiliations
Mohamed B Ibrahim, Aamir A Hamza, Omer M Ismail
Keywords
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