A study on Acute Intestinal Obstruction

INTRODUCTION: Acute intestinal obstruction is one of the most common cause for admissions in surgical side worldwide. It is a common and potentially dangerous complication needing surgery. Patients present with a wide range of complaints and difficulty often arises in making a correct diagnosis. Detailed history and thorough physical examination is often helpful in diagnosis and planning treatment. ELIGIBILITY CRITERIA: All patients admitted and diagnosed as having dynamic intestinal obstruction and undergone emergency surgery were analysed and considered for study. This was a prospective study undertaken in K.A.P.V. Government Medical College Hospital, Trichy from September 2010 to November 2012. EXCLUSION CRITERIA: 1. All paediatric patients, 2. Patients who were conservatively managed, 3. All cases of inguinal hernia with intestinal obstruction which reduced spontaneously. AIM OF THE STUDY: 1. To identify the causes of acute intestinal obstruction in K.A.P.V. Government Medical College, Trichy. 2. To analyse various clinical presentations of acute intestinal obstruction in our hospital. 3. To analyse management and outcome of patients with acute intestinal obstruction in our hospital. MATERIALS AND METHODS: This is a prospective study of 100 patients admitted with features of Acute Intestinal obstruction in K.A.P.V. Govt. Medical college Hospital, Trichy from September 2010 to November 2012. This study includes the patients of Trichy district and adjacent districts of Karur, Dindigul and Namakkal who were admitted for acute intestinal obstruction and emergency surgery done for it. A proforma is attached to all the case sheets who were diagnosed as having Acute Intestinal Obstruction. Abdomen X-ray is taken as a routine in all suspected cases. All the data were entered in the proforma and the patients were followed till discharge or death. The details of signs and symptoms, diagnosis , surgical procedures, complications and outcome of the patient were entered in the proforma and they were tabulated and analysed. All the data obtained was entered in the master chart and tabulated for comparison and reference. The observations were compared with the recent studies and literature available and conclusions were drawn. OBSERVATION: A total of 100 patients admitted during the period from September 2010 to November 2012 at K.A.P.V. Government Medical college Hospital were included in the study. After admission the data regarding the patient were entered into the proforma and followed up until discharge/death. The data of 100 patients were entered in the master chart and analysed. CONCLUSION: In conclusion, most of the recent advances in the management of bowel obstruction consist of developments in the imaging modalities available to assist in the diagnosis itself, particularly with regard to the distinction between partial and complete obstruction. Unfortunately little progress has been made to enable physicians to detect early reversible strangulation. Because of the inability to detect reversible ischemia, there is a substantial risk of progression to irreversible ischemia when surgery is delayed for an extended period of time, especially in the setting of suspected complete obstruction. It is encouraging, that some advances have been made in understanding the patho physiology and prevention of adhesion formation. Research efforts in the future should continue to focus on these issues as well as on the development of methods to better recognize early signs of strangulation