A Clinico Pathological study of Acute Small Bowel Obstruction and its Management at Tertiary Care Hospital

Abstract

Background:Intestinal obstruction remains as an important surgical emergency. The patients require early resuscitation and appropriate surgical management. This study was undertaken in to study the clinico pathology of small bowel obstruction and its management.Material and methods:A prospective study was undertaken in 60 patients of intestinal obstruction. The patients were subjected for complete history, physical examination, laboratory and radiological investigations. Surgical management was based on the etiology of obstruction following a prompt resuscitation of patients in emergency ward.Results:Majority of the cases in this study belonged to 41 – 50 years of age group and were females. More than half of the patients presented within 1 – 2 days of onset of symptoms. The patients also manifested with vomiting, Distension, Constipation, Fever and dehydration. Tenderness and guarding was present in more than half of the cases in this study. These clinical manifestations can be attributed to the strangulation which is common in patients presenting late to the hospital. About 23.3% had adhesions and bands as the main etiology for the intestinal obstruction followed by jejunal stricture and Ileal stricture. The inflammatory changes on histopathology were common. Wound infection was the common complication in 6.7% of the cases. Conclusion:This study concludes that, early diagnosis and prompt operative treatment with post operative treatment can reduce the mortality in intestinal obstruction cases.