Mechanical intestinal obstruction: etiology and management in adults at civil hospital, Karachi

ABSTRACT

To determine the etiological factors, management and outcome of mechanical intestinal obstruction in adults at Civil Hospital, Karachi. The hospital records of all patients operated on for mechanical intestinal obstruction in Civil Hospital, Karachi, over a period of one year [July 2006 to June 2007] were reviewed. Signs and symptoms with duration, etiology, surgical management, morbidity and mortality, apart from demography, were recorded. Patients were followed until their discharge. A total of 119 patients, 74 male and 45 female, with a mean age [ +/- SD] of 37.29 [ +/- 16.08] years were operated on during the study period. Their mean [ +/- SD] duration of symptoms was 4.1 [ +/- 3.9] days. Obstructed external hernias were the most common cause of intestinal obstruction, seen in 36 [30.2%] patients, followed by intestinal tuberculosis in 24 [20.2%] patients. Stoma formation was the most common surgical procedure performed in 40 [33.6%] patients followed by hernia repair, with or without resection, and anastomosis of bowel in 36 [30.2%] patients. Complications were documented in 34.4% of patients. Mortality was 9.2% during the hospital stay. Obstructed external hernias were the commonest cause of intestinal obstruction followed by intestinal tuberculosis. Stoma formation was the commonest surgical procedure performed. During the first year of surgical training, all residents should master the skills of making an appropriate stoma, while during the second year they should be able to manage obstructed hernias properly