STUDY OF CURRENT PATTERN OF MECHANICAL INTESTINAL OBSTRUCTION IN ADULTS AT DMCH, LAHERIASARAI, BIHAR

Abstract

Objective : To evaluate the current pattern of mechanical bowel obstruction in adults. Study design : Descriptive case series. Place & Duration of study : Upgraded Department of Surgery, DMCH, Laheriasarai, Bihar, from March 2019 to February 2020. Methodology : The criteria for diagnosis were on the basis of history, clinical findings, radiological examination, exploration of abdomen and histopathological confirmation in selected cases. Results : A total of 252 surgically treated cases of mechanical bowel obstruction were included. Out of the total, 187 (74.2%) presented with acute and 65 (25.8%) with sub-acute intestinal obstruction. The mean age was 37.4 years with male to female ratio of 2:1. Abdominal tuberculosis was found in 77 (30.6%) patients. Among the other causes bands/adhesions were found in 57 patients (22.6%) and obstructed hernias in 44 patients (17.5%). In 161 patients (64%) the intestinal obstruction was without gut compromise, while in 91 patients (36%) strangulated bowel obstruction was present. Forty patients (15.9%) developed postoperative complications mainly wound sepsis and chest problems in the form of atelectasis and pneumonia. The mortality rate was 2.4% (n 6). Conclusions : Tuberculosis is still the common cause of intestinal obstruction, with overall mortality rate of 2.4% which needs attention.