Epidemiological Study Assessing Clinic-Etiological Spectrum of Acute Small Intestinal Obstruction: An Observational Study

Description

Abstract (English)

Aim: The aim of the present study was to evaluate the common etiological factor related to small bowel
obstruction in adult patients.
Material & Methods: The cross-sectional study was conducted in the Department of General Surgery, for the
duration of 24 months. Total 200 patients age above 15 years were studied after taking informed consent from
patient/relatives.
Results: 130 patients were male and 70 were females. All the patients were categorized in different age group,
39 patients belong to 15-25 years age group, 69 patients were in 26-40 years, 52 patients were in 41-55 years, 26
patients were in 56-70 years and remaining 14 were having age above 71 years. The cardinal signs and
symptoms were present in almost all the patients. Abdominal pain was present in 192 patients, vomiting in 150
patients, tenderness in 180 patients, absolute constipation in 162 patients, abdominal distension in 186 patients,
rebound tenderness in 108 patients, significant finding on per rectal examination in 108 patients,
absent/decreased bowel sound in 70 patients, increased bowel sound in 130 patients and palpable mass and
swelling was present in 50 patients. Out of 200 patients, Adhesions were present in 36 patients, Hernias in 40
patients, Malignancy in 20 patients, intestinal volvulus in 10 patients, diverticulum in 4 patients, strictures in 12
patients, intestinal tuberculosis in 20 patients, fecal impaction in 6 patients and superior mesenteric artery
syndrome in 3 patients. Remaining patients were having non-mechanical (adynamic) intestinal obstruction. Out
of these patients, 8 patients were having gangrenous ileum, two female patients were having pelvic abscess and
24 patients were having intestinal obstruction due to unknown paralytic ileus cause.
Conclusion: The causes of intestinal obstruction are variable in different parts of the world. Adhesions are the
most common cause of bowel obstruction. The treatment in each patient should be individualized. Atrial of
conservative management should be planned in all cases before embarking to a surgical intervention except in
patients where strangulation is suspected.