Current pattern of mechanical intestinal obstruction in adults

To evaluate the current pattern of mechanical bowel obstruction in adults. Descriptive case series. Surgical unit III and IV Bolan medical college/ complex hospital Quetta, from June 2007 to July 2009. The criteria for diagnosis were on the basis of history, clinical findings, radiological examination, exploration of abdomen and histopathological confirmation in selected cases. A total of 252 surgically treated cases of mechanical bowel obstruction were included. Out of the total, 187 [74.2%] presented with acute and 65 [25.8%] with sub-acute intestinal obstruction. The mean age was 37.4 years with male to female ratio of 2:1. Abdominal tuberculosis was found in 77 [30.6%] patients. Among the other causes bands/adhesions were found in 57 patients [22.6%] and obstructed hernias in 44 patients [17.5%]. In 161 patients [64%] the intestinal obstruction was without gut compromise, while in 91 patients [36% strangulated bowel obstruction was present. Forty patients [15.9%] developed postoperative complications mainly wound sepsis and chest problems in the form of atelectasis and pneumonia. The mortality rate was 2.4% [n 6]

Management of symptomatic Meckel's diverticulum

The objective of this study was to evaluate the management of symptomatic Meckel's diverticulum. This study was conducted between November, 1999 to November, 2001 at three surgical and one pediatric surgical unit in Sandeman [Prov] Hospital Quetta.A total of 1995 patients were operated with provisional diagnosis of acute abdomen out of which 20 cases were of Meckel's diverticulum. In most of the patients resection of Meckel's diverticulum or resection of gut with Meckel's diverticulum was done and anastomosis performed. The mean age was 16.05 years with male: female ratio 9:1. Abdominal pain was the most common symptom [75%]. Operative findings were volvulus around a band between Meckel's diverticulm and umbilicus in four [20%], omphalodiverticular fibrous band causing kinking of the adjacent gut in two [10%], ileocolic intussusception due to Meckel's diverticulum in two [10%], volvulus around a band with gangrene of gut in two [10%], mesodiverticular band entrapping a small bowel loop in one [5%], inflamed perforated Meckel's diverticulum causing peritonitis and intestinal obstruction in one each [5%], inflamed thick edematous Meckel's diverticulum in six [30%], patent vitellointestinal duct with Meckel's diverticulum in one [5%] and bleeding Meckel's diverticulum in one [5%]. The patients who presented with acute abdomen, no preoperative diagnosis regarding involvement of diseased Meckel's diverticulum can be reached with most of the available modalities of investigation in this region. In children presenting with acute abdomen Meckel's diverticulum must be kept in mind