Volume 19, Issue 1
DOI: 10.53555/03276716.2010.01
Clinical Profile and Management Outcomes of Acute Intestinal Obstruction at a Tertiary Care Hospital: A Cross-sectional Study
Abstract
Introduction: Acute intestinal obstruction represents a common surgical emergency with significant morbidity and mortality. This study aimed to analyze the clinical profile, etiology, diagnostic approaches, management strategies, and outcomes of patients presenting with acute intestinal obstruction at a tertiary care hospital.
Methods: A hospital-based cross-sectional study was conducted at the Department of General Surgery, National Institute of Medical Sciences (NIMS), Jaipur, from January 2009 to December 2009. Consecutive sampling was employed to recruit all patients presenting with clinical and radiological evidence of acute intestinal obstruction. Data was collected using structured proforma and analyzed using SPSS version 15.0. Descriptive statistics and appropriate comparative tests were applied with statistical significance set at p<0.05.
Results: A total of 186 patients were studied with male predominance (60.2%) and peak incidence in 21-40 years age group (36.0%). Abdominal pain was universal (100%), followed by vomiting (93.5%), distension (90.3%), and constipation (83.9%). Adhesions were the leading cause (33.3%), followed by malignancy (21.5%) and hernias (19.4%). Small bowel obstruction was more common (69.9%) than large bowel obstruction (30.1%). Plain radiography showed positive findings in 89.8% cases, while CT scan demonstrated 95.5% diagnostic accuracy. Conservative management succeeded in 67.9% of attempted cases, while surgical intervention was required in 58.1% patients with 94.4% success rate. Overall complication rate was 18.3% with mortality of 3.8%.
Conclusion: Acute intestinal obstruction predominantly affects young males with adhesions being the commonest etiology. Early diagnosis and appropriate management result in favorable outcomes with acceptable morbidity and mortality rates.
Keywords
Acute intestinal obstruction, Small bowel obstruction, Adhesions, Emergency surgery, Tertiary care hospital