A STUDY ON THE SURGICAL MANAGEMENT OF ACUTE INTESTINAL OBSTRUCTION IN ADULTS IN A DISTRICT HEADQUARETRS HOSPITAL

Dr. K. Sridharan*

ABSTRACT

Introduction:Intestinal obstruction remains as one of the most common intra-abdominal pathologies encountered by surgeons whether it is caused by hernia, neoplasm, adhesions or any biochemical disturbances. Intestinal obstruction of the small or large bowel continues to be an important cause of morbidity and mortality. The objective of this study is to analyse the clinical features, treatment and outcome of patients with acute intestinal obstruction along with the cause of obstruction and causes of bowel ischaemia, necrosis and perforation. Methodology: The materials for the clinical study of bowel obstruction were collected from various Cases getting admitted to surgical wards. 50 cases of acute intestinal obstruction have been studied. Patients were belonging to the age groups from 12 years to 85 years, paediatric age group (<12 yrs) is excluded from this study. Results: The prevalent age groups are 31-40 and 51-60 age group with around 20% each in the total study. The most common cause of acute intestinal obstruction in the adults in this study series has been post-operative Adhesions (40%) and the next being obstructed Hernia (30%). The clinical features of abdominal pain, vomiting, constipation have been the main symptoms in this study. The commonest type of obstruction has been due to adhesions or band arising from the previous surgeries.The complication rate in this study was 18%. Overall mortality of this study was 14%. Discussion and Conclusion: Acute intestinal obstruction remains to be an important surgical emergency in the surgical field. Success in the treatment of acute bowel obstruction depends mainly on the early diagnosis and efficient management and treating the pathological effects of the obstruction as much as the treatment of the cause itself. Erect abdomen X-ray is a valuable tool in the diagnosis of acute intestinal obstruction. Postoperative adhesions have been the most common cause to produce bowel obstruction. Clinical, radiological and operative findings when put together can diagnose the intestinal obstruction. Mortality is still significantly high in acute intestinal obstruction in adults.

Keywords: Acute intestinal obstruction, Treatment, Outcome.