European Journal of Molecular & Clinical Medicine

Abstract

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.