A clinical study of acute intestinal obstruction in adults at a tertiary care centre in north india

Junaid Alam., Aditya Varshney., Mohhamad Aslam and Yusuf Afaque

Introduction- Intestinal obstruction occurs due to the failure of passage of contents through intestine. It can be because of a mechanical or functional pathology. Main causes of Intestinal obstruction may vary from country to country or among zones within a specific country. The aim of this study was to evaluate the etiology, presentation, management strategies, and outcomes of patients with acute mechanical Intestinal obstruction at a tertiary care hospital in Uttar Pradesh, North India.
Material and Methods- This prospective study was conducted in Department of Surgery, Jawaharlal Nehru Medical College Hospital, Aligarh Muslim University, Aligarh, India between October 2015 to September 2017. Total 263 patients were enrolled in our study who were diagnosed to have acute intestinal obstruction.
Observation and Results- Acute intestinal obstruction was diagnosed with males preponderance (66.15%). The commonest age group affected was 41-50 years. Regarding clinical presentation of our patients, Abdominal pain was the most common presenting symptom and abdominal distension was the most common physical finding on clinical examination. The most common radiological finding was multiple air fluid levels seen on X-ray abdomen. In our patients, the main cause of obstruction was Ileocaecal tuberculosis followed by Adhesions and Bands. Small bowel obstruction was present in 81.36% cases and large bowel obstruction in 18.63% cases. The most common surgical procedure was segmental bowel resection with end to end anastomosis. Most of the cases recovered without any complications (78.32%).Wound dehiscence, burst abdomen was the major cause of morbidity. 5.32% mortality rate was reported in our study during post operative period and this was commonly seen in patients with Strangulated hernia and increased age.
Conclusion- Ileocaecal tuberculosis was the main causes of acute intestinal obstruction in our region. An algorithmic diagnostic approach based on different radio-logical imaging, blood investigations, biopsy and appropriate management with a rational combination of anti-tubercular therapy can reduce the morbidity of this easily curable yet potentially lethal disease.

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DOI: http://dx.doi.org/10.24327/ijcar.2017.8621.1394