Prospective Clinical Study of Intestinal Obstruction it's Changing Etiology and Management Protocols

Abstract

Introduction: Bowel obstruction remains one of the most common intra-abdominal problems Faced by general surgeons in their practice whether caused by hernia, neoplasm, adhesion correlated to biochemical disturbances intestinal obstruction of either the small or large bowel continues to be a major cause of morbidity and mortality.Materials and Methods: The materials for this clinical study on intestinal obstruction were collected from Cases admitted to various surgical wards in KR Hospital, Mysore attached to Mysore Medical College, during the period from January 2018 to June 2019, fifty cases of intestinal obstruction have been studied. Patients belonged to the age group ranging from 15 years to 85 years, Paediatric age group being excluded from this study. The criteria for selection of cases was based on the clinical history, physical examination findings, radiological and haematological investigations.Results: The incidence of acute bowel obstruction in adult age group was studied from the cases admitted in Department of General Surgery, KR Hospital, Mysore attached to the Mysore Medical College, Mysore during the period January 2018 to June 2019. During my study period of 20 months, the total number of admissions in surgery department were 16,533 patients. From this 240 cases with acute intestinal obstruction were treated during this period which comprise 1.5% of the total admissions. Among these cases which were surgically managed, 50 cases were selected randomly for the present study. In The present study, the most common symptoms were pain abdomen (88%) and vomiting (78%), and the most common signs were tachycardia (74%) and visible intestinal peristalsis (80%).Conclusion: Postoperative adhesions are the common cause to produce intestinal obstruction. Clinical radiological and operative findings put together can diagnose the intestinal obstruction. Mortality is still significantly high in undiagnosed case of malignancy which presented in emergency with intestinal obstruction. Earlier diagnosis and timely intervention are associated with excellent prognosis. Delayed diagnosis leading to strangulation and increased age are associated with poor outcomes.