Clinico-pathological study of intestinal obstruction and its management

Abstract

Background: Intestinal obstruction is one of the most common surgical emergencies, for which the therapeutic strategy has progressed through several evolution. The aim was to study the various etiologies, spectrum of clinical features, factors affecting type of management- conservative or operative, various surgical procedures and its outcome in relation to etiological factors in patients of intestinal obstruction.Methods: It is prospective study including 200 patients fulfilling the inclusion criteria were part of this study conducted from March 2015 to September 2016 with a provisional diagnosis of intestinal Obstruction carried out in Gandhi Medical College associated Hamidia Hospital, Bhopal, Madhya Pradesh, India.Results: The patients were mostly males and from age group 30 -50 years and least were from 70-80 years. The most common clinical symptom was abdominal pain and the sign was tenderness, least common were irreducible hernia and mass per abdomen. Commonest etiology was adhesion and least was worm infestation. Most patients were treated by operative procedure in comparison to conservative management, commonest procedure done was laparotomy with resection and anastomosis and hernioplasty was least common. The histopathology study of resected specimens reveals inflammation as the commonest and the malignancy as the least one. The mortality was highest in patients of adhesions and the least in patients of obstructed hernia. Discharge rates were maximum in patients of adhesion and minimum in patients of volvulus.Conclusions: In our study it had been observed that early diagnosis, adequate preoperative hydration, prompt investigations and early operative intervention improves survival in patients of intestinal obstruction. If preoperative preparation is improved and anesthetic management is more skillful, the mortality from abdominal exploration should approach to minimum.