A Study on Small Bowel Obstruction

Manivannan, K (2006) A Study on Small Bowel Obstruction. Masters thesis, Thanjavur Medical College, Thanjavur.


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INTRODUCTION: Acute small bowel obstruction continues to be a frequent emergency till date. It accounts for 2/3 of abdominal cat atrophies. Delay in diagnosis has a direct bearing on the morbidity and mortality. Physical signs and their interpretation reach a high pinnacle of importance in the diagnosis. Frequently an urgent and all-important decision has to be reached by their aid alone. It is one of the emergencies where as quickly as possible we act, the result will be remarkable. It is one of the gravest emergencies that reveal the talents of the surgeon in all aspects. Investigations and resuscitation protocol for all patients were identified. All the cases in the present study were treated surgically. AIM OF THE STUDY: 1. To Evaluate the Common Causes of Acute Small Bowel Obstruction. 2. To Identify the Etiopathogensis. 3. To Evaluate the Various Mode of Presentation. 4. To Study the Various Modalities of Treatment in this Center. 5. To Evaluate the Morbidity And Mortality of Acute Small Bowel Obstruction. MATERIALS AND METHODS: A total of 109 cases of acute intestinal obstruction admitted in all surgical wards, Thanjavur Medical College Hospital, Thanjavur from November 2004 to MARCH 2006. Both men and women more than 12 years of age totaling 109 cases with features of acute intestinal obstruction were chosen. The paediatric patients were not included in this study. The characteristic clinical features of acute intestinal obstruction like abdominal pain, vomiting, constipation/obstipation, abdominal distension and clinical sings including Fever (37.2o). Tachycardia (>100/mt), Palpable abdominal mass if any were noted. All the patients were subjected to investigation while resuscitative measures were on progress. 1. Urine-albumin, sugar, 2. Hb%, 3. Blood Grouping with typing, 4. WBC count, 5. Blood-urea, sugar, 6. Serum Electrolytes-in cases with severe dehydration, 7. X-ray chest PA view, 8. ECG, 9. Plain X-ray abdomen erect and supine position and result were recoded. Investigations 4 and 9 were taken as a tool to identify the pathology while others were meant for assessing the patient's fitness for surgery. After adequate preoperative preparation all patients were subjected to surgical Procedures appropriate to the condition and preoperative pathology were noted. The etiological incidence, Sex incidence, Age incidence, incidence of Strangulation, value of plain X-ray Abdomen in diagnosis of acute intestinal obstruction, importance of early treatment were studied. CONCLUSION: 1. The major cause of acute intestinal obstruction is still External hernia (44.03%)here. Among this, inguinal hernia alone accounts for 79.16% in total. 2. Adhesive obstruction accounts for 39.449% in total, of which the Post-inflammatory adhesion is the major cause. 3. Abdominal tuberculosis accounts for 6%. 4. The incidence of small bowel volvulus is 2%. 5. Morbidity in our study is 11% and Mortality is 3.66% 6. Plain X-ray abdomen is a valuable in the diagnosis of the acute obstruction (73%) and hence it is considered as minimal investigation before surgery. 7. Early surgical intervention and antibiotics has reduced the mortality of the simple bowel obstruction. 8. In Strangulated obstruction, the mortality rate is still significantly more, due to aged, associated disease like diabetic mellitus, heart disease, renal the mortality. 9. Early diagnosis and early surgical intervention is the key to reduce the mortality.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Small Bowel Obstruction.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 14 May 2018 15:16
Last Modified: 14 May 2018 15:16
URI: http://repository-tnmgrmu.ac.in/id/eprint/7824

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