A CLINICAL STUDY OF INTESTINAL OBSTRUCTION AND ITS SURGICAL MANAGEMENT IN RURAL POPULATION
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2013, Vol 2, Issue 21
Abstract
[b]BACKGROUND[/b]: The diagnosis and management of the patient with intestinal obstruction is one of the more challenging emergency that a general surgeon can come across. Although the mortality due to acute intestinal obstruction is decreasing in urban areas due to early presentation and prompt medical attention, the same is not true in rural population because of late presentation with complications. With better understanding of pathophysiology, improvement in diagnostic techniques, fluid and electrolyte correction, much potent antibiotics and surgical management the complications arising due to late presentation can be limited. However, still mortality ranges from 3% for simple obstruction to as much as 30% when there is vascular compromise or perforation of the obstructed bowel .This is further influenced by the clinical setting and related co-morbidities. [b]OBJECTIVES[/b]: To study various causes, clinical features, and modalities of treatment of intestinal obstruction and their outcome. [b]METHODOLOGY[/b]: A total of 50 cases of intestinal obstruction, after admission in our hospital that were surgically managed, were chosen by simple random technique for the study. Statistical analysis was done using SPSS software. RESULTS: Intestinal obstruction is more common in the age group of 30-60 years. Small bowel obstruction is more common than large bowel obstruction. Four cardinal features of intestinal obstruction are pain abdomen, vomiting, distension and constipation. Most common etiological factor is postoperative adhesions followed by abdominal hernia. Malignancy as a cause for obstruction is more common in large bowel than small bowel. Intravenous fluids and electrolytes, gastrointestinal aspiration, antibiotics and timed appropriate surgery are still the mainstay of treatment. [b]CONCLUSION[/b]: Intestinal obstruction still remains a common and important surgical emergency. Obstruction due to adhesions is increasing in incidence due to increased abdominal & pelvic surgeries. The obstruction due to external hernias is decreasing due to early elective surgeries. The morbidity and mortality depends on the age of the patient, etiology of obstruction, site of obstruction, state of hydration, viability of the bowel, delay in diagnosis and surgical intervention and associated medical illness
Authors and Affiliations
Naveen N, Avijeet Mukherjee, Nataraj Y. S, Linge Gowda
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