Background: Acute intestinal obstruction is one of common abdominal emergency and is associated with significant morbidity and mortality especially if it progresses to bowel ischemia. The diagnosis and management of the patient with intestinal obstruction is one of the more challenging emergencies that a general surgeon can come across. Although the mortality due to acute intestinal obstruction is decreasing with better understanding of pathophysiology and improvement in diagnostic techniques, fluid and electrolyte correction, much potent anti-microbials but still mortality ranges from 10-15% and more so in developing countries.Methods: The study will be conducted in the department of general surgery with symptoms and signs of acute intestinal obstruction admitted in the surgical ward. Fifty cases of intestinal obstruction have been studied. Patients belonged to all the age groups except infants are included in present study. The criteria for selection of cases was based on clinical history, physical findings, radiological and haematological investigations. The study was divided into clinical study, investigations and treatment. The results are tabulated stressing on following points age, sex, symptoms examination findings, investigations, abnormalities, probable causative factors, operative findings and operative procedure adopted and complications if any.Results: The commonest cause of intestinal obstruction in the adults in this study series was postoperative adhesions (36%) followed by obstructed/strangulated hernia (26%). Malignancy of the large bowel was seen in 9 cases constituting 18% of cases where as incidence of Volvulus of bowel was 4% in this series. Although pulmonary tuberculosis is more prevalent in India due to advent in use of antitubercular drugs incidence of abdominal tuberculosis is becoming less. In present study incidence of ileocaecal tuberculosis was 10%. One case of mesenteric ischaemia was present in our study.Conclusions: Acute intestinal obstruction remains an important surgical emergency in the surgical field. Success in the treatment of acute intestinal obstruction depends largely upon its early diagnosis, skilful management and treating the pathological effects of the obstruction just as much as the cause itself.

Background: Patients with right lower abdominal pain in whom routine investigations and sonography are negative, is challenging to the surgeons. In many patient’s laparotomy is the only alternative.Laparoscopy is defined as the technique in which abdomino-pelvic cavity is visualized through small openings in the wall of abdomen through instruments. In patients with RIF pain, only diagnostic laparoscopy can be considered as the gold standard and provide correct diagnosis and concurrently may prove to be therapeutic Aim: The Aim of the study is to evaluate role of laparoscopy in right lower abdominal pain with uncertain diagnosis. Settings and Design: In this prospective study, patients with right lower abdominal pain with uncertain clinical diagnosis, USG abdomen and laboratorial investigation, coming to surgery OPD of our institute, over a period of 24 months were considered for Diagnostic Laparoscopy. Material and Methods: Diagnostic laparoscopy was performed in 174 patients. These patients presented with right lower abdominal pain and undergone investigations for the same. Results: Laparoscopy yielded positive findings in 170 (97.7%) of these patients. Appendicitis and gynaecological pathology, abdominal tuberculosis, were the major findings. Therapeutic procedures were performed in 165 patients (laparoscopically 158). There was only one complication in this series, in which patient developed surgical site infection on post-operative day 2. So, the patients who had remained as undiagnosed otherwise, were diagnosed and given appropriate treatment. Conclusion: This study establishes role of Diagnostic Laparoscopy as a safe and one of the most prolific investigative tools in undiagnosed right lower abdominal pain.

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