Pattern of Adult Mechanical Intestinal Obstruction in Delta State University Teaching Hospital

ABSTRACT

Introduction: Adult mechanical intestinal obstruction(AMIO) is a frequent challenge to most practicing generalsurgeons, Contemporary literature review suggests a changein the pattern of causes with bands and adhesions now beingthe commonest cause in some reports. Delta state universityteaching hospital (DELSUTH) is a state-owned tertiary healthfacility in Delta State, Nigeria.This study aims to highlight theaetiological pattern of AMIO in DELSUTH and its associatedmorbidity and mortality.Material and Methods: All adult patients with clinical andradiological evidence of mechanical intestinal obstructionwere prospectively studied over a 32 months period.Result: 65 consecutive adult patients with AMIO were studiedwhich constitutes 22% of all admitted surgical emergenciesseen in our services. Female Male ratio 1.81, Age range was16 to 100 years and mean age 42.5 years. Post operative bandsand adhesions was the commonest cause of AMIO (46.1%).The commonest clinical presentation was abdominal pain(95.4%) and 56.9% of patients had a previous abdominalsurgical scar. Obstetric and gynaecological operations werethe most common cause of bands and adhesions (46.7%) nextwas appendectomies (23.3%). Non operative managementfor band and adhesions was successful in 53.3% and meanduration for symptom resolution was 4 days. Commonestcomplication was superficial surgical site infection (16%).mortality rate was 15.3%.Conclusion: Bands and adhesions are the commonestcause of AMIO in DELSUTH and are related to Obstetric/gynaecological operations and open appendectomies. Thisdiffers from previous studies in developing countries whereobstructed hernia was the dominant cause.