A Retrospective Study of Intestinal Obstruction and Anastomotic Leak in Emergency and Sepsis Cases.

ABSTRACT

Intestinal obstruction is one of the most common intra-abdominal problems dealt by general surgeons. The morbidity and mortality are much higher than many diseases. If diagnosed & treated early, the recovery time, morbidity & mortality are much less. Hence the need for the study. METHODSWe have analysed 216 cases of intestinal obstruction done by a single surgeon in one hospital in the last three decades. Differences in the selection, surgical skill, capability, & post-operative care management are excluded by including a single surgeon’s (1st Author) operated cases. Only operated cases are included in the study. Conservatively managed patients are not included in this study. RESULTSFemales are more affected 56%, than 44% males. If Pelvic pathology cases are excluded – both sexes are equally affected. Small intestine was affected in 88 % of patients. Anastomotic leak occurred in 8 patients (3.7%). Burst abdomen occurred in 4 patients - 1.85%. Re-exploration was done in 13 patients (6.0%). LAMA & death together accounted for 6 cases (2.8%). Success rate of all operations was 97.2%. CONCLUSIONSFemale sex is more commonly effected. Adhesion & bands are major causes of small bowel obstruction. Anastomotic leak is common in strangulated bowels with associated with septic shock. PGA (Vicryl) & PDS are better than catgut in decreasing the leak rate. Mortality rate is more in anastomotic leak patients.