“Study of Large Bowel Obstruction in Adults”

Abstract

Post-operative outcomes of large bowel obstruction in adults. METHODS: This is a prospective observational study of large bowel obstruction in adults and was carried out from Nov 2010 to Oct 2012. RESULTS: A total of 211 cases of intestinal obstruction were diagnosed out of these 25(11.85%) cases were of large bowel obstruction. Maximum patients 8(32%) cases belonged to age group 51-60yrs and 15(60%) cases were males. Obstipation seen in 25(100%), pain 22(88%), distension 21(84%), tenderness 22(88%) and increased bowel sounds 21(84%). X-ray and ultrasonography was useful in 21(84%) cases while CT scan was used in only 7 cases and proved 100% effective.13(52%) cases were of sigmoid volvulus, 1(4%) of caecal volvulus and 9(36%) cases of malignancy.15(60%) cases underwent primary resection anastomosis and 10(40%) cases had a decompressive colostomy.8(32%) patients developed immediate wound complication, 3(12%) cases had anastomotic leak, 1(4%) case developed burst abdomen and 6(24%) cases had septicaemia. Mortality of the study was 6(24%) cases. CONCLUSION: Patients with large bowel obstruction in adults form a small percentage of patients. Commonest causes are sigmoid volvulus and obstructing colorectal malignancies. X-ray abdomen, Ultrasound of abdomen and Computerized Tomography of abdomen are very helpful in diagnosing. Single stage resectional procedure without colostomies can be done in patients even in emergency surgeries and Proximal diverting colostomies may be safely performed in patients with pre-existing sepsis, shock, gangrene of large bowel and excessively loaded colon with reversal of colostomies and a definitive procedure may be performed later, after stabilisation of patients. Post-operative complications are more because of late presentation associated with comorbidities and large bacterial load of colon during resectional procedure large bowel obstruction carries an increased rate of mortality because of its presentation in old age with associated comorbid factors requiring major resectional procedures. INTRODUCTION: Intestinal obstruction accounts for one of the most common surgical emergencies resulting into high morbidity and if timely aid isn't provided mortality sets in .The incidence of this condition has not changed though a different etiological pattern is present from place to place and time to time over the last century. The mode of presentation is same in all but certainly with varied causes. With time, better understanding of pathophysiology, improvement in radiological techniques of diagnosis, high degree of refinement in correction of fluid and electrolyte imbalance, introduction of antibiotics with effective bacteriological control, introduction of techniques in

Prevalence of Intestinal Obstruction in Patients Attending Tertiary Care Institute of Gujarat

“…This in turn has reduced the incidence of strangulation of bowel, which was major cause of mortality in already ill patient. [9] Early diagnosis of obstruction skillful operative management, proper technique during surgery and intensive postoperative treatment carries a grateful result. [6] Hence the aim of the present study was to know the various causes of intestinal obstruction and also to analyse the symptomatology of intestinal obstruction.…”