Spectrum of Etiology of Intestinal Obstruction - A Hospital-based Study
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 5
Abstract
Introduction: Bowel obstruction remains one of the most common intra-abdominal problems of utmost complexity faced by general surgeons despite better understanding of altered physiology in disease and improved surgical techniques. Aim: The aim is to study the epidemiology, incidence, management, and outcomes of intestinal obstruction. Materials and Methods: This study comprises of 118 patients of acute small and large bowel obstruction managed in a single surgical unit in the Department of Surgery, Government Medical College, Jammu, over 12 months. The diagnosis of intestinal obstruction was made based on detailed history, clinical examination, radiological examination (usually plain X-ray abdomen), and histopathology of the excised gut lesion. Special investigations including contrast studies and contrast-enhanced computed tomography abdomen were done in selected patients only. Patients of gastric outlet obstruction and anorectal malformation were excluded from the study. Results: Acute intestinal obstruction comprised of 5.77% of total number of admissions, age spectrum ranging from 2 days to 82 years with peak incidence in the age group of 30-50 years (28.81%). Males were more commonly affected in all age groups with male-to-female ratio 1.6:1. Small bowel involvement was observed in 78.9% and large bowel in 21.1% of these patients. The most common cause of intestinal obstruction was found to be bands and adhesions (40%), followed by non-specific cases (13%), hernias (8.5%), and bolus obstruction (6%). Conclusion: Adhesions are the most common cause of bowel obstruction. The treatment in each patient should be individualized. A trial of conservative management should be planned in all cases before embarking to a surgical intervention except in patients where strangulation is suspected.
Authors and Affiliations
Naveed Anjum Qureshi, Sunil Kumar Bhat, Bikramjit Singh Sodhi
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