Background Intestinal obstruction (IO) is a common cause of acute abdomen globally, it remains challenging as it increases surgical financial expenditure while also causing major morbidity. Clinically it presents with nausea, vomiting, colicky abdominal pain and cessation of bowel movements or passage flatus and stool. Diagnosis, especially in resource limited settings, can be clinical but is usually confirmed radiologically. We studied the current diagnosis, management and outcomes of IO in Mulago Hospital. Materials and methods This was a prospective study done at all the surgical units of Mulago from January to May 2014 to assess general diagnosis and management of IO. Ethical approval was got in line with Helsinki declaration, we used pretested and validated questionnaires to collect data. Informed consent was got with eligible and consenting/assenting patients that fitted the inclusion criteria of age and presenting with suspected intestinal obstruction. Uni-variate and bi-variate variables analysis was done plus measures of association. Results We enrolled 135 patients, excluded 25 and recruited 110 patient. We had more males than females i.e. 71.8% males and 28.2% females. Colicky abdominal pain, abdominal distension, and vomiting were commonest symptoms, then abdominal distension, increased bowel sounds and abdominal tenderness were the commonest signs. Most patients’ (51%) were diagnosed radiologically with a lesser number clinically diagnosed. “Dilated bowel loops” was the commonest radiological sign. Surgery was the main stay of management at 72.7% while 27.3% were conservatively managed. Postoperatively the bowels opened averagely on the 3rd post-operative day (POD) with return of bowel sounds occurring on 5th POD. Most discharges (73%) occurred by the 7th POD. Unfavourable outcomes were prolonged hospital stay followed by wound sepsis (surgical site infection) and then Mortality. Conclusion This study noted that In Mulago we mostly diagnosed patients radiologically with most surgically managed and which is similar to regional practices. Postoperatively bowel opening happening on third POD with return of bowel sounds on fifth POD. Prolonged hospital stay followed by wound sepsis and then mortality were commonest unfavorable management outcomes.
BACKGROUND: Intestinal Obstruction (IO) is among the commonest causes of acute abdomen worldwide and globally it remains a challenge because it is a major cause of morbidity and surgical financial expenditure. Clinically it presents with nausea, vomiting, colicky abdominal pain and cessation of bowel movements or passage flatus and stool. Diagnosis can be clinical but is confirmed usually by radiologic imaging. We studied the current diagnosis, management and outcomes of IO in Mulago HospitalMATERIALS AND METHODS: This was a Prospective Descriptive Study in all the surgical units of Mulago from January to May 2014. Ethical approval was got in line with Helsinki declaration and then a pretested and validated questionnaire was used to collect data. Informed consent was got with eligible and consenting/assenting patients recruited among those patients of all ages and sex presenting with suspected Intestinal Obstruction. Uni-variate and bi-variate of the variables plus measurements of associations were done.RESULTS: We enrolled 135 patients, excluded 25 and recruited 110 patient with more males than females i.e. 71.8% males and 28.2% females. Colicky abdominal pain, abdominal distension, and vomiting were the 3 commonest symptoms with abdominal distension, increased bowel sounds and abdominal tenderness as commonest signs. Majority of the patients were diagnosed radiologically (51%) and the rest (48.2%) clinically diagnosed accounting. “Dilated bowel loops” was the most frequent radiological sign. Return of bowel sounds occurred within 5 days of the POD, while opening of bowels on average, occurred on the 3rd POD. The mean day of discharge was the 5th POD and 73% of the patients were discharged by the 7th Post-Operative Day. The commonest unfavourable management outcome noted was prolonged hospital stay followed by wound sepsis (Surgical Site Infection) and MortalityCONCLUSION: Majority of the patients were diagnosed radiologically (51%). surgical management was done for 72.7% of the cases and 27.3% conservatively managed. Prolonged hospital stay was the commonest unfavorable outcome of management
INTRODUCTION: The burden of surgical disease is largely unknown in low and middle-income countries, where access to care is limited. This is especially true of pediatric surgical S98
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