CLINICAL STUDY AND MANAGEMENT OF ACUTE INTESTINAL OBSTRUCTION

Background: The etiology of acute intestinal obstruction, which is one of the commonest surgical emergencies, varies between countries, and has also changed over the decades'.The current study aims to review the various causes, clinical features and the outcome of surgical procedures in relation to etiological factors in 50 intestinal obstruction patients admitted at Government General Hospital, Kurnool (Oct 2019 to Oct 2021). Methods: This was a prospective study of 50 patients admitted with a diagnosis of acute intestinal obstruction at GGH, Kurnool between Oct 2019- Oct 2021. Data related to the objectives of the study were collected and analysed by comparing with various standard studies. Results: Acute intestinal obstruction was the diagnosis in 3% of all patients admitted, with a M: F ratio of 1.38:1. The commonest age group affected was 31-40 years. In our patients, the main cause of obstruction was obstructed hernia (36%), due to lack of awareness among the rural population. Adhesions and bands (26%) were the second most common cause of intestinal obstruction followed by sigmoid volvulus (12%), TB abdomen (8%) and malignant obstruction (6%). Surgery was the mainstay of treatment, with herniorraphy, adhesiolysis and resection - anastomosis being the most commonly performed procedures. Post-operative complications noted were wound infection (12%), respiratory infection (6%) and prolonged ileus (6%). In the present study of 50 cases, 5 patients (10%) died due to septicemia and MODS. Conclusion: This study demonstrates that the pattern of intestinal obstruction differs from the Western world with obstructed hernias rather than adhesions being the most common cause. Majority of the patients need timely surgical relief of obstruction to avoid the development of peritonitis, sepsis and multi-organ failure.