An Observational study of patients undergoing conservative Vs surgical management for adhesive small bowel obstruction

Varun, Arunagiri (2014) An Observational study of patients undergoing conservative Vs surgical management for adhesive small bowel obstruction. Masters thesis, Kilpauk Medical College, Chennai.

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Abstract

Adhesive small bowel obstruction is the common cause of small bowel obstruction. The common surgeries which lead to adhesion formation are pelvic surgeries. But the surgeries which are due to infective pathology like Acute Appendicitis, Acute Cholecystitis and Peritonitis due to Adhesion formation forms more adhesion than inflammatory causes. OBJECTIVES: 1. The Primary Objective of this study is observation and comparison of symptoms with the type of management in the same cohort of patients with previous surgery. 2. The secondary objectives of this study are; a. Demographic analysis of the cohort. b. To analyse the symptoms of the patients suffering from small bowel obstruction. c. To analyze the indication for previous surgery the patient has undergone. 3. Develop a hypothesis and scoring system for the symptoms for adhesive small bowel obstruction. In this study, the patients who underwent previous surgery were observed. Out of 100 patients who were observed, the primary objective is to analyze the specific symptom which is responsible for surgical management. Other data analyses like demographic analysis, analysis of previous surgery are also done. MATERIALS AND METHODS: Inclusion criteria: 1. Patients who have symptoms of abdominal pain, abdominal distension, vomiting, fever, constipation or obstipation are chosen. 2. Abdominal X-Ray must show either dilated bowel loop or Multiple air fluid level are chosen. 3. Both male and female patients are chosen for the study. 4. Patients who have undergone previous surgery were chosen. 5. Patients age must be 18 years – 75 years. 6. Mentally sound patient who gives previous surgical history was chosen. 7. Patients with repeated episodes of abdominal pain with hospital admissions after intra abdominal or pelvic surgeries have been chosen. Exclusion criteria: 1. Patients who have undergone surgery for intra abdominal malignancy were excluded. 2. Patients whose age was less than 18 and greater than 75 were excluded. 3. Pregnant women were excluded. In this study, when the patient is diagnosed to have Adhesive Small Bowel Obstruction, it is observed that fever has high sensitivity to subject the patient for surgical management. A hypothesis is developed from this observational study. Scoring system for the symptoms is assigned. The sensitivity and specificity for each of the symptoms to subject the patient for surgical management are measured and the accordingly score is assigned. The sensitivity of the scoring system is yet to be done in a big small size.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Adhesive Small Bowel Obstruction ; ASBO ; Seprafilm ; Conservative management of ASBO ; Surgical management of ASBO ; Adhesiolysis.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 06 Jul 2018 16:25
Last Modified: 07 Jul 2018 16:07
URI: http://repository-tnmgrmu.ac.in/id/eprint/8664

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