Pattern of Acute Intestinal Obstruction and Outcome of Management in SRHF, Mizoram, India

ABSTRACT

Background: The purpose of this study was to evaluate the aetiological pattern of acute intestinal obstruction, symptomatology, physical findings and outcome of management in State Referral Hospital, Falkawn (SRHF)/Mizoram Institute of Medical Education and Research (MIMER), Mizoram, India. Methods: The study was carried out on fifty (50) consecutive cases of acute intestinal obstruction admitted in the Department of Surgery, SRHF/MIMER, Mizoram, India, during a period of 1st January 2015 to 31st December 2017. Results: In this series, seven aetiologies were identified namely, adhesions & bands (28%), cancer (26%), hernia (22%), intussusception (8%), volvulus (6%), tuberculosis (6%) and Meckel’s diverticulitis (4%) which are discussed in detail. All the patients complained of pain abdomen and 66% of them experienced nausea whereas 60% had vomiting. Distension of abdomen was complained by 80% while absolute constipation was complained by 82%. Per abdominal examination revealed distension in 92%, guarding in 38%, localized tenderness in 20% and palpable mass in 32%. Out of 50 cases, complications were encountered in 7 cases which constitute 14%. The mortality in this study was 4 (8%). Conclusion: The pattern of acute intestinal obstruction studied in order of frequency of occurrence is band/adhesion, cancer, hernia, intussusception, volvulus, tuberculosis and Meckel’s diverticulitis. The outcome of management was evaluated by analyzing the post-operative complications and mortality. The present study showed that, differentiation between simple and strangulation obstruction on clinical ground and investigative parameters was not possible with certainty.