Case study of 100 cases of intestinal obstruction

Varghese, Thomas (2013) Case study of 100 cases of intestinal obstruction. Masters thesis, Tirunelveli Medical College, Tirunelveli.


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INTRODUCTION: Intestinal obstruction is a common cause of acute abdomen handled by surgeons. Obstruction of inguinal hernias and adhesive obstructions make up a large number of these cases. The clinical presentation varies depending on the type, site, duration etc. Timely evaluation, diagnosis and management plays an important role in disease outcome. This study deals with epidemiology, etiology, clinical features, morbidity and mortality. AIM OF STUDY: 1. To study various causes of intestinal obstruction. 2. To study various presentations of the cases. 3. To study epidemiology of cases. 4. To study various surgical procedures and its outcome. 5. To study factors affecting morbidity and mortality. METHODOLOGY: The materials for the clinical study of intestinal obstruction were collected from cases admitted to various surgical wards of Tirunelveli medical college hospital, during the period from February 2011 to October 2012,hundred cases of intestinal obstruction have been studied. Patients belonged to the age groups ranging from 12 years to 88 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 sub acute intestinal obstruction treated conservatively,patients with a dynamic obstruction and paediatric patients were excluded from the study, and only those cases of acute intestinal obstruction which were managed surgically were studied to establish the aetiology 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 supported by haematological and radiological examinations. Inclusion criteria: 1. All cases > 12 years age, 2. Both males and females, 3. Small bowel and large bowel obstruction, 4. Cases of acute intestinal obstruction. Exclusion criteria: 1. All cases < 12 years age, 2. Adynamicintestinalobstruction, 3. Sub acute cases. 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 skillful 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. 1. The study showed that inguinal hernias are the most common cause of intestinal obstruction. 2. Males were predominantly affected. 3. Age group between 41 – 70 years was the most commonly affected. 4. Patients taking mixed diet was predominantly affected. 5. Most common symptom was vomiting. 6. Most common sign was tachycardia. 7. Mortality was found to be highest with colonic obstruction due to growth. 8. Total number of Anastamotic leak and Wound infection were more in males, though a disproportionately higher incidence occurred in women inspite of their lower numbers. 9. Most common postoperative complication was wound infection. 10. Resection and anastomosis as well as release and herniorrhaphy were the most commonly done surgical procedures.

Item Type: Thesis (Masters)
Uncontrolled Keywords: intestinal obstruction ; Case study ; 100 cases.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 09 Jun 2018 18:16
Last Modified: 09 Jun 2018 18:16

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