Syam D, Badekila H* and Francis J
Background: Bowel obstruction is one of the most common intra-abdominal problems faced by general surgeons. This study is designed to assess epidemiology, clinical presentation, diagnostic modalities of dynamic (mechanical) intestinal obstruction and the outcome of surgical management of the same.
Methods: After ethical committee approval and informed consent, a total of 48 patients who presented to Yenepoya Medical College Hospital, Mangalore, Karnataka with dynamic intestinal obstruction were selected. All surgically managed cases of dynamic obstruction above the age group of 18 years were included. Patients less than 18 years of age and those managed conservatively were excluded. Results: It was found that the mean age at presentation was 48.54 years with females (52.1%) being more commonly affected. Pain (100%) was the most consistent symptom, and tenderness (91.7%) the commonest sign noted, with Contrast CT abdomen being diagnostic in 100% of cases. Total Leukocyte count or CRP was not found to be reliable indicators to predict patient outcome. CEA had a significant correlation with a diagnosis of malignant obstruction. Emergency diversion colostomy or ileostomy (35.4%) was the commonest surgical procedure performed followed by adhesiolysis (16%). Malignancy (41.7%) was the commonest cause followed by Adhesions (14.6%) and Obstructed Hernia (14.6%). Conclusions: Abdominal pain with tenderness on examination was the most common presentation. Total Leukocyte Count and CRP were found to be unreliable as severity indicators, whereas CECT Abdomen was conclusive in all cases. Malignant obstruction was the leading cause in this study. The initial surgical management commonly involved a diversion procedure, with good outcome.
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