CAUSES OF ACUTE INTESTINAL OBSTRUCTION PRESENTING TO SURGICAL EMERGENCY DEPARTMENT OF TERTIARY CARE HOSPITAL

Objective: To determine the etiological spectrum of acute intestinal obstruction in surgical emergency department of our hospital. Methodology: The study cross sectional study was conducted in department of surgery, Nishtar hospital, Multan. Duration of study was 6 months. Diagnosed cases (age above 15 years) of intestinal obstruction with the help of X-ray and Ultrasonography were included in the study. All the patients were selected by non-probability purposive sampling technique. All patients were initially assessed after resuscitation in emergency room. The decision, to operate or manage conservatively, was taken by a consultant. Emergency laparotomy was done and operative findings were recorded. Results: Total 130 patients were enrolled in the study .78 patients were male and 52 were female. 43 patients were in age group 26-40 years, 36 patients were in 41-55 years. The cardinal signs and symptoms were present in almost all the patients. Abdominal pain was present in 128 patients, vomiting in 102 patients, tenderness in 118 patients, absolute constipation in 112 patients and abdominal distension in 119 patients. Out of 130 patients 96 patients were having intestinal obstruction due to mechanical causes like Adhesions were present in 21 patients, Hernias in 26 patients, Malignancy in 10 patients and intestinal tuberculosis in 17 patients. Remaining 34 patients were having non-mechanical (adynamic) intestinal obstruction. Out of these 34 patients 18 patients developed paralytic ileus due to gastrointestinal tract perforations (ileum, duodenal, appendix etc.). 26 patients were managed conservatively and 104 patients underwent surgery. Most common post-surgical complication was wound infection and wound dehiscence. The outcome observed in patients were as, 106 patients improved, 12 patients developed morbid condition, 6 lost to follow up and 6 patient died. Keywords: Intestine, Mechanical (Dynamic), Intestinal obstruction, Hernias, Adhesions, Tuberculosis, Adynami