A STUDY OF INTESTINAL OBSTRUCTION CONSERVTIVE VERSUS SURGICAL MANAGEMENT

Abstract

Intestinal obstruction refers to the impairment to the abnormal passage of intestinal contents which can be due to the mechanical obstruction or failure of normal intestinal motility in the absence of an obstructing lesion. Extra luminal, intrinsic, and intraluminal are three categories of small bowel obstruction. In this retrospective observational study, patients presenting to the A&E department of surgery unit who had similar condition were screened. The study is based on total of 60 patients out of which 22 patients managed conservatively whereas 38 patients were managed surgically. Common symptoms were abdominal pain and vomiting. 20 patients had previous abdominal surgery; 16 had exploratory laparotomy for abdominal trauma, perforation, gynae procedure, etc. 4 patients developed characteristic of obstruction following laproscopic. 14 patients undergone surgery while 6 patients were managed conservatively. Surgically managed duration was 2.8 days on average. Mean duration for conservatively managed patients was 2.9 days. Among the surgically managed patients, 11 had strictures, 14 had adhesion, 8 had obstructed hernia, 1 had intussusception, and 4 had abdominal TB. Based on the cause of the obstruction, surgical procedure was carried out. History of abdominal surgery was found to be more frequent in whom obstruction was relieved conservatively. The conclusion of the study is that adhesions based on previously conducted surgery are important causes of SBO. Two common method of managing the condition is conservative management and surgical management. The criteria for utilizing particular method is based on several patient related factors. Clinical decisions guide the management of SBO and timing of surgical intervention.