Mohanraja, P (2013) Prospective Study on Epidemiology, Management and Outcome of Acute Intestinal Obstruction in Adults in Rajiv Gandhi Government General Hospital. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION: Bowel obstruction remains one of the most common intraabdominal problems faced by general surgeons in their practice whether caused by hernia, neoplasm, adhesions or related to biochemical disturbances intestinal obstruction of either the small or large bowel continues to be a major cause of morbidity and mortality.1 They account for 12% to 16% of surgical admissions for acute abdominal complaints. Manifestations of acute intestinal obstruction can range from a fairly good appearance with only slight abdominal discomfort and distension to a state of hypovolemic or septic shock (or both) requiring an emergency operation. To identify and analyse the clinical presentation, management and outcome of patents with acute mechanical , obstruction along with the etiology of obstruction and the incidence and causes of bowel ischaemia, necrosis and perforation. The death due to acute intestinal obstruction is decreasing with better understanding of pathophysiology, improvement in diagnostic techniques, fluid and electrolyte. Early diagnosis of obstruction skillful operative management, proper technique during surgery and intensive postoperative treatment carries a grateful result. AIMS AND OBJECTIVES: 1. To study the various modes of presentation, various Causes, importance, Early recognition, diagnosis, management. 2. To study the influence of various factors like, age, sex, diet, socio- economic status in the pathogenesis of acute intestinal Obstruction in adults. 3. To study the morbidity and mortality rates in acute intestinal Obstruction. MATERIAL AND METHODS: The materials for the clinical study of intestinal obstruction were collected from cases admitted to various surgical wards in Rajiv Gandhi Government General Hospital from June 2012 to December 2012, fifty cases of intestinal obstruction have been studied. Patients belonged to the age groups ranging from 12 years to 85 years, paediatric age group is excluded from this study. The criteria for selection of cases was based on clinical history, physical findings, radiological and haematological investigations. Patients who were having subacute intestinal obstruction treated conservatively were excluded from the study, and only those cases of acute intestinal obstruction which were managed surgically were studied to establish the pathology of intestinal obstruction with an aim to know the mode of presentation, physical findings, radiological and haematological findings, operative findings and outcome of acute intestinal obstruction. After the admission of the patient, clinical data were recorded as per Proforma .The diagnosis mainly based on clinical examination and often Study divided into supported by haematological and radiological examinations. METHODS: a. Clinical study, b. Investigations, c. Treatment. Study was conducted under the following headings: a. History taking, b. Physical examination, c. Laboratory examination, d. Radiological examination – Plain X-ray erect abdomen, e. Ultrasound examination in selected cases, f. Surgical treatment and results, g. Follow-up. DATA ANALYSIS AND RESULTS: The incidence of acute intestinal obstruction in adult age group was studied from the cases admitted in Department of Surgery of Rajiv Gandhi Government General Hospital from June 2012 to December 2012, fifty cases of intestinal obstruction have been studied. data regarding the symptoms and signs and laboratory investigations has been adopted in 50 cases during the study period. During the period of 6 months, the total number of admissions in surgery were 12,233 cases. Of which 228 cases of acute intestinal obstruction were treated during these period which comprise 1.9% of total number of admissions among these surgically treated cases, 50 cases were randomly selected for the present study. Total number of emergency surgeries done in the department of Surgery were 1,569 and acute intestinal obstruction in this group consisted of about 14.53% of these surgeries. CONCLUSION: Acute intestinal obstruction remains an important surgical emergency in the surgical field. • Success in the treatment of acute intestinal obstruction depends largely upon early diagnosis skilful management and treating the pathological effects of the obstruction just as much as the cause itself. • Erect abdomen X-ray is valuable investigation in the diagnosis of acute intestinal obstruction. • Postoperative adhesions are the common cause to produce intestinal obstruction. Clinical radiological and operative findings put together can diagnose the intestinal obstruction. • Mortality is still significantly high in acute intestinal obstruction.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Epidemiology ; Management and Outcome ; Acute Intestinal Obstruction ; Adults ; Rajiv Gandhi Government General Hospital ; Prospective Study |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Devi S |
| Date Deposited: | 26 Mar 2018 14:13 |
| Last Modified: | 26 Mar 2018 14:13 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/6590 |
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