A Study of Acute Intestinal Obstruction

Rasheeda Begum, U (2008) A Study of Acute Intestinal Obstruction. Masters thesis, Kilpauk Medical College, Chennai.

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Abstract

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. AIM OF THE STUDY: 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 prospective study of 100 patients with acute intestinal obstruction admitted in the Department of General Surgery at the Government Kilpauk medical college and hospital from May 2005 to May 2007. 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 death. The observations were compared with the current literature on acute intestinal obstruction and conclusions were drawn. CONCLUSION: The study of acute intestinal obstruction was aimed at identifying the etiological factors, mode of presentation, surgical procedures employed with relevant investigational procedures. Acute intestinal obstruction is one of the most common emergencies requiring surgical intervention. A proper and complete bedside clinical examination by the surgeon is more superior than investigational procedures. Hernias continues to be the commonest cause for obstruction and strangulation. A delay in diagnosis could be fatal. Adhering to the basic principles of preoperative preparation like nasogastric suctioning, correcting dehydration and electrolyte imbalances can significantly lower the morbidity and mortality. Surgical intervention remains the cornerstone of treatment. With timely management, most patients have an excellent prognosis.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Acute Intestinal Obstruction.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 05 Jun 2018 17:41
Last Modified: 06 Jun 2018 03:18
URI: http://repository-tnmgrmu.ac.in/id/eprint/8225

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