Acute Mechanical Bowel Obstruction: Clinical Presentation, Etiology, Management, and Outcome

Abstract

Purpose: The aim of this study was to investigate the clinical presentation and etiology of acute mechanical bowel obstruction while assessing the incidence of complications such as intestinal perforation and necrosis. Patients and Methods: This prospective observational study was conducted at Al-Thawra General Modern General Hospital (TMGH) in Sana'a, Yemen, spanning the period from October 2022 to October 2023. A total of 106 patients diagnosed with AMBO were enrolled, and comprehensive data were collected on demographics, clinical presentation, management strategies, surgical interventions, etiology, complications, and patient outcomes. Results: The study included 106 patients with AMBO. The majority of patients were male (66.0%), and the most affected age group was 31-60 years (51%). The common presenting symptoms included constipation (90.6%), vomiting (96.2%), and absolute constipation (75.5%). Adhesions were identified as the predominant cause of AMBO (41.5%), followed by hernias and large bowel masses. Surgical intervention was performed in the majority of cases (71.7%), with resection and anastomosis (29.2%) being the most frequently performed procedures. Intraoperative complications included bowel ischemia (17.0%), necrosis (12.3%), and perforation (6.6%). Postoperative complications primarily manifested as wound infections (31.6%). The majority of patients showed improvement and were discharged (89.6%), but the mortality rate was 10.4%. Conclusion: Our study on AMBO in Yemen found a higher prevalence in males and middle-aged individuals, with small bowel obstruction being more common. Adhesions, hernias, and large bowel masses were identified as the primary causes. Surgical intervention was frequently required, with resection and anastomosis being the most common procedures. Postoperative complications, including wound infections, were observed. Further multicenter studies are warranted to validate and generalize the findings of this investigation.