A Retrospective Analytical study on Pattern of Intestinal Obstruction

Katheresan, V (2017) A Retrospective Analytical study on Pattern of Intestinal Obstruction. Masters thesis, Stanley Medical College, Chennai.


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INTRODUCTION: Acute intestinal obstruction is an enigma with its versatile presentation and wide spectrum of management options available. It presents a constant challenge to the surgeon both in diagnosis and in judgment as regards the line of management for that specific patient, for those specific parameters and for that specific moment in the course of the disease. Intestinal obstruction is a dynamic condition where the parameters are changing as the clock ticks on. ‘Time’ means everything in intestinal obstruction and a delay in diagnosis or management increases the mortality. With a wide range of conditions known to cause obstruction, the surgeon should be aware of the commonest causes in the geographical region of presentation. Keeping with these principles, this study hopes to discuss the various causes and clinical presentations, sift out the reliable signs and symptoms and the most common causes. Diagnostic modalities have reached new heights in present times, but our study focuses on using the available basic modalities to further the diagnosis. Different treatment modalities and their outcome in terms of death/morbidity have been tabulated. OBJECTIVES: 1. To identify the cause of acute intestinal obstruction, 2. To discuss the various clinical presentation, 3. To discuss the various diagnostic modalities, 4. Various modalities of management of acute intestinal obstruction, 5. To study the outcome of patients with acute intestinal obstruction. MATERIALS AND METHODS: This is a retrospective study of 40 patients with acute intestinal obstruction admitted in the Department of General Surgery at the Government Stanley medical college and hospital. From the time of presentation the cases were followed up till the time of discharge / death. X ray abdomen erect was routinely taken for all patients. The details of symptoms at presentation, the diagnosis entertained, investigations reports, type of surgery and outcome have all been recorded and tabulated in a master chart for reference and comparison. The final outcome has been sub grouped based on the degree of incapacitation to deat. The observations were compared with the current literature on acute intestinal obstruction and conclusions were drawn. RESULTS: In our setup there is higher incidence of intestinal obstruction among males. 28 – males, 12 – females. As far as age distribution is concerned the age range was14- 72 YRS., Most common occurrence between 30 to 60 years. Most common cause of intestinal obstruction was band/adhesion. followed by irreducible hernias (inguinal/umblical/incisional/epigastric)/malignancy etc,. Commonest symptom in our study was pain followed by vomiting, distension, constipation. Abdominal tenderness, tachycardia, with hyper dynamic or absent bowel sounds were the commonest signs. CONCLUSION: As far as age distribution is concerned the age range was 14 – 72 years., most common occurrence between 30 to 60 years, Abdominal pain is the most common presenting symptom (100%) followed by vomiting (96%) and distention of abdomen (94%). The most common sign was tachycardia (96%), tenderness which was present in (96%) of the cases, followed by guarding (84%) & rigidity which was present in (82%) of patients. Of the 40 cases the commonest cause of acute intestinal obstruction is adhesions/bands (14 cases). Hernias were present in 10 cases, and is the second commonest cause.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Tenderness, tachycardia, guarding, rigidity, bowel sounds, constipation, abdominal distension, vomiting,
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 18 Mar 2020 03:34
Last Modified: 18 Mar 2020 07:42
URI: http://repository-tnmgrmu.ac.in/id/eprint/12322

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