European Journal of Molecular & Clinical Medicine

Background: Acute intestinal obstruction (AIO) is a common surgical emergency,
requiring urgent diagnosis and prompt treatment. The cause of bowel obstruction has
changed dramatically during the past century. Varying etiologic pattern has been noted
in developing nations as compared to the industrialized nations.
Materials and Methods: This was a prospective study comprising of all the 68 patients
admitted between August 2020 and August 2021 in the Department of General Surgery,
Govt Medical Collge & Hospital, Suryapet with a clinical diagnosis of AIO and
operated. The aim was to study the etiological pattern and other characteristics of AIO
and to look for any variation in the pattern in this region.
Results: Cases operated for AIO constituted 6.84% of all emergency surgeries. The
most common cause of AIO was complicated hernia (n=23, 33.82%) followed by
adhesions (n=14, 20.59%) and abdominal tuberculosis (n=10, 14.71%). The mean age of
presentation was 46.55 years ± 15.76 years and male to female ratio was 2:1. The most
common symptom was pain abdomen (n=63, 92.65%) while the most common sign was
tachycardia (n=66, 97.06%). The most common preceding surgery leading to AIO due
to adhesions was open appendicectomy and the most common complication was surgical
site infection (n=15, 19.12 %). There were 4 mortalities (5.88%).
Conclusion: Obstructed hernia, though the leading etiology for AIO in this study, has
lower incidence compared to similar studies, mostly due to improving socio-economic
status of people and better accessibility to health care in this region. Adhesions, has a
considerably high incidence, probably due to increased number of timely surgeries for
diseases that previously went untreated, such as surgeries for various intra-abdominal
malignancies. Tuberculosis is the third most common cause of AIO in this study and is
mainly attributed to increasing incidence of HIV and its coexistence with tuberculosis.

Adhesive disease of the abdominal cavity, complicated by acute intestinal obstruction, is one of the most difficult diseases of the abdominal cavity in terms of treatment and diagnosis. The urgency of the problem is determined by the complexity of prevention and treatment of the studied complication, the widespread increase in surgical activity, the expansion of indications for performing operations of extended volume and combined interventions for diseases of the abdominal cavity and retroperitoneal space. Analysis of the literature shows that acute intestinal obstruction occupies one of the first places among urgent pathology of the abdominal cavity in terms of the frequency of complications and fatal outcomes. An increase in the number of patients, the severity and recurrent nature of the disease, difficulties in diagnosis, unsatisfactory immediate and long-term results of treatment of patients with adhesive small bowel obstruction, as well as a high percentage of disability determines the relevance of the chosen topic.