AETIOLOGICAL FACTORS IN MECHANICAL INTESTINAL OBSTRUCTION

Authors

  • Shawana Asad
  • Hafizullah Khan
  • Ishtiaq Ali Khan
  • Sher Ali
  • Salma Ghaffar
  • Zia ur Rehman

Abstract

Background: Intestinal obstruction occurs when the normal flow of intestinal contents isinterrupted. The most frequent causes of intestinal obstruction are postoperative adhesions andhernias, which cause extrinsic compression of the intestine. Less frequently, tumours or strictures ofthe bowel can cause intrinsic blockage. Objective of the study was to find out the various aetiologicalfactors of mechanical intestinal obstruction and to evaluate the morbidity and mortality in adultpatients presenting to Surgical ‘A’ unit of Ayub teaching hospital with mechanical intestinalobstruction. Methods: This cross-sectional study was conducted from March 2009 to September,2009. All patients presenting with intestinal obstruction and were above the age of 12 years wereincluded in the study. Patients with non-mechanical obstruction were excluded from the study andthose who responded to conservative measures were also excluded. Results: A total of 36 patientswith age ranging from 12 to 80 years (Mean age 37.72±19.74 years) and male to female ratio of1.77:1, were treated for mechanical intestinal obstruction. The most common cause for mechanicalintestinal obstruction was adhesions (36.1%). Intestinal tuberculosis was the second most commoncause (19.4%), while hernias and sigmoid volvulus affected 13.9% patients each. Malignancies werefound in 5.6% cases. Conclusion: Adhesions and Tuberculosis are the leading causes of mechanicalintestinal obstruction in Pakistan. Although some patients can be treated conservatively, a substantialportion requires immediate surgical intervention.Keywords: Intestine, Mechanical (Dynamic), Intestinal obstruction.

References

Ismail, Khan M, Shah SA, Ali N. Pattern of dynamic Intestinal

Obstruction in adults. J Postgrad Med Inst 2005;19(2):157–61.

Evers BM. Small Intestine. In: Townsend CM, Beauchamp RD,

Evers B M, Mattox KL. Sabiston Textbook of Surgery. 17th ed.

Philadelphia:. Saunders Elsevier; 2004. p. 1323–42.

Zahra T, Sultan N. Prevalence of Intestinal T.B amongst cases of

bowel obstruction. Pak J Surg 2004;20(2): 82–5.

Baloch NA, Babar KM, Mengal MA, Babar SAA. Spectrum of

Mechanical Intestinal Obstruction. J Surg Pak 2002;7(1):7–9.

Qureshi MI, Anwar I, Dar HM, Ahmad A, Durrani KM.

Managing small intestinal obstruction: Proceeding Shaikh Zayed

Postgrad Med Inst 2005;19(1):19–23.

Chouhery AK, Azam M. An etiological spectrum of mechanical

intestinal obstruction. Pak Armed Forces Med J 2004;54(1):19–24.

Macutkiewicz C, Carlson GL. Acute Abdomen: Intestinal

obstruction. Surg Int 2005;70:10–4.

Menzies D, Ellis H. Intestinal obstruction from adhesions —how

big is the problem? Ann R Coll Surg Engl 1990(72):60–3.

Markogiannakis H, Messaris E, Dardamanis D, Pararas N,

Tzertzemelis D, Giannopoulos P, et al. Acute mechanical bowel

obstruction: clinical presentation, etiology, management and

outcome. World J Gastroenterol 2007;13:432–7.

Drozdz W, Lejman W, Tusiński M. Mechanical bowel

obstruction. Surgical problem at the turn of the XIX-XX century,

and the XX-XXI century. One institutional experience. Przegl

Lek 2005; 62(2):105–10.

Sule AZ, Bada D, Nnamonu MI. Postoperative non-adhesive

mechanical intestinal obstruction: a review of seven cases. Niger

J Med 2009;18(1):63–7.

Weibel MA, Majno G. Peritoneal adhesions and their relation to

abdominal surgery. Am J Surg 1973;126:345–53.

Published

2011-09-01

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