CLINICAL SPECTRUM AND MANAGEMENT OUTCOMES OF ACUTE INTESTINAL OBSTRUCTION: A CROSS-SECTIONAL STUDY AT A TERTIARY CARE CENTRE
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Keywords
Acute intestinal obstruction, adhesions, surgical emergencies, conservative management, intestinal tuberculosis
Abstract
Background: Acute intestinal obstruction (AIO) is a common surgical emergency with variable clinical presentations and outcomes. Understanding its etiology and management patterns in different regions can help tailor timely interventions.
Objectives: To evaluate the etiological factors, clinical features, treatment modalities, and outcomes of patients presenting with AIO.
Methods: A hospital-based cross-sectional study was conducted at a tertiary care center over 18 months, including 146 patients aged 10–80 years presenting with signs of acute intestinal obstruction. Detailed history, clinical evaluation, radiological, and biochemical investigations were undertaken. Management approaches were categorized into conservative and surgical, and outcomes were analyzed statistically.
Results: The most affected age group was 51–60 years (21.2%), with a male predominance (57.5%). Abdominal pain (87.0%), vomiting (61.0%), and obstipation (59.6%) were the leading presenting complaints. Adhesions (23.3%), tuberculosis (14.4%), and malignancy (12.3%) were the leading causes. Conservative management was sufficient in 51.4% of cases, especially in subacute and tuberculosis-related obstructions. Surgical intervention (48.6%) was mostly required for malignancy, obstructed hernia, and perforations. A statistically significant association was noted between etiology and management modality (P<0.001).
Conclusion: Adhesions and tuberculosis continue to be major causes of AIO in developing countries. Early diagnosis and tailored treatment significantly influence outcomes. A structured protocol considering etiology-based management can reduce morbidity and mortality.
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Dr. Vidhi Satya
Final year, Post Graduate, Department of General Surgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.
Dr (Maj) Anurag Bijalwan
Professor and Head of Department, Department of General Surgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.
Dr Pradeep Singhal
Professor, Department of General Surgery, Department of General Surgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.
Dr Madhukar Maletha
Professor, Department of Pediatric Surgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.