PATTERNS OF INTESTINAL OBSTRUCTION IN ADULTS: ETIOLOGY, MANAGEMENT, AND OUTCOMES AT LADY READING HOSPITAL PESHAWAR

Abstract

Objective: To determine the etiological spectrum, management modalities and clinical outcome of intestinal obstruction in the adults who underwent surgery for intestinal obstruction at a tertiary-care surgical unit.

Study Design: Descriptive cross-sectional study.

Place and Duration of Study: Department of General Surgery, Lady Reading Hospital Peshawar, Pakistan.

Methodology: A total of 120  adult patients (aged 18 years or older) were admitted with a diagnosis of intestinal obstruction and were enrolled in a consecutive manner. Each patient was assessed through a detailed clinical history, clinical examination and followed up clinical examination until the end of the study, along with the results of radiological investigations, intra-operative findings and surgeries performed, post-operative findings and the final outcome. This information was captured using a structured proforma. The patients were treated either conservatively or surgically depending on their clinical status. The analysis of the data was performed in SPSS version 26.

Results: The mean age was 42.3 ± 14.6 years with a male predominance (65.0%). The most common cause was post-operative adhesions (31.7%) followed by obstructed or strangulated hernia (21.7%), intestinal tuberculosis (18.3%) colorectal malignancy (15.0%) and volvulus (8.3%). Of those, 76.7% (92 patients) required surgical management, with the most frequently performed surgeries being adhesiolysis (32.6%) and resection with anastomosis (26.1%). The total complication rate of patients undergoing surgery was 40.2%, and the mortality rate was 5.8%.

Conclusions: Post-operative adhesion and external hernia continue to be the common causes of intestinal obstruction at this tertiary centre. Time of presentation is a major factor in determining morbidity and mortality and surgical intervention is essential in achieving optimized outcomes within a timely manner.