DOI: http://dx.doi.org/10.18203/2349-2902.isj20204676

Clinical study and surgical management of acute intestinal obstruction in the adults

Jaydeep M. Gadhavi, Rahul Charpot

Abstract


Background: The aim of this study was to evaluate the treatment protocol of intestinal obstruction in adults.

Methods: A total of 60 patients diagnosed with intestinal obstruction were included in the study. All the patients with the provisional diagnosis of the intestinal obstruction were assessed clinically after the admission. Appropriate surgical procedures were implemented on the patients with clear signs and symptoms of acute abdominal obstruction. Surgery adopted and criteria for deciding the procedure were noted.

Results: For the management of small bowl obstruction. Adhesiolysis was done in 14 patients, resection and anastomsis was done in 8 patients, in 4 patients the band release procedure was performed, hernia repair was done in 8 patients, followed by resection, hernia repair, volvulus derotation and Mekels diverticulectomy was done in 2 patients respectively. For the management of large bowl obstruction the Colostomy was done in 8 cases, resection and anastomosis in 4 cases, intussusception milking in two cases, volvulus derotation was done in 2 cases and right hemicolectomy was done in 4 cases of CA ascending colon.

Conclusions: Success in the treatment of acute intestinal obstruction depends largely upon early diagnosis skilful management and treating the pathological effects of the obstruction just as much as the cause itself. 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 acute intestinal obstruction.


Keywords


Adhesions, Intestinal obstruction, Large bowl, Small bowl, Treatment

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References


Thampi D, Tukka VN, Bhalki N, Sreekantha RS, Avinash S. A clinical study of surgical management of acute intestinal obstruction. Int J Res Health Sci. 2014;2:299-308.

Dasappagol MD. Study of causative factors of intestinal obstruction in pediatric age group. RGUHS, 2009.

Taourel P, Kessler N, Lesnik A, Blayac P, Morcos L, Bruel J. Non-traumatic abdominal emergencies: imaging of acute intestinal obstruction. European radiology 2002, 12:2151-60.

Naveen N, Mukherjee A, Nataraj Y, LingeGowda S. A clinical study of intestinal obstruction and its surgical management in rural population. J Evol Med Dent Sci. 2013;2:3636-50.

Mohanraja P. Prospective study on epidemiology, management and outcome of acute intestinal obstruction in adults in Rajiv Gandhi Government General Hospital. Madras Medical College, Chennai, 2013.

Markogiannakis H, Messaris E, Dardamanis D, Pararas N, Tzertzemelis D, Giannopoulos P, et al. Acute mechanical bowel obstruction: clinical presentation, etiology, management and outcome. World J Gastroenterol. 2007;13:432.

Wangensteen OH, Paine JR. Treatment of acute intestinal obstruction by suction with the duodenal tube. J Am Med Assoc. 1933;101:1532-9.

Zielinski MD, Bannon MP. Current management of small bowel obstruction. Adv Surg. 2011;45:1-29.

Miller G, Boman J, Shrier I, Gordon PH. Etiology of small bowel obstruction. Am J Surg. 2000;180:33-6.

Ojo E, Ihezue C, Sule A, Ismaila O, Dauda A, Adejumo A. Aetiology, clinical pattern and outcome of adult intestinal obstruction in JOS, north central Nigeria. Afr J Med Med Sci. 2014;43(1):29.

Sannappanavar NY. A study of surgical management of intestinal obstruction. RGUHS. 2013.

Nasiruddin S, Patil S, Pinate AR. A clinical study of aetiology of acute intestinal obstruction. Int Surg J. 2019;6:783-7.

Pawade A, Waterson K, Laussen P, Karl TR, Mee RB. Cardiopulmonary bypass in neonates weighing less than 2.5 kg: analysis of the risk factors for early and late mortality. J Cardiac Surg. 1993;8:1-8.

Souvik A, Hossein MZ, Amitabha D, Nilanjan M, Udipta R. Etiology and outcome of acute intestinal obstruction: A review of 367 patients in Eastern India. Saudi J Gastroenterol. 2010;16(4):285.