A Study Of Intestinal Obstruction Conservtive V/s Surgical Management

Indian Journal of Applied Basic Medical Sciences
Year: 2019, Volume: 21(B), Issue. (2)
First page: (82) Last page: (90)
Online ISSN: 2249-7935
Print ISSN: 0975-8917
doi:

A Study Of Intestinal Obstruction Conservtive V/s Surgical Management 
Asit V. Patel1,Shaishav V. Patel2*, Swapnil O. Vanparia3 , Pratik Patel4, Suyash Singodiya5
1Head of the department of General Surgery, 2Assistant Professor, 3-5Resident
Department of  General Surgery, AMCMET Medical college and LG Hospital Maninagar , Ahmedabad Pin  380008 
Corresponding author email id:   shaishav.ptl@gmail.com

Online Published on 02-Jul-2019

ABSTRACT

INTRODUCTION: Intestinal obstruction can be defined as impairment to the abnormal passage of intestinal contents that may be due to either mechanical obstruction or failure of normal intestinal motility in the absence of an obstructing lesion. The causes of a small bowel obstruction can be divided into three categories: extra luminal, intrinsic, Intraluminal. METHODOLOGY This is a retrospective observational study. All patients presenting to the Emergency and Out Patient Department of surgery unit with features of intestinal obstruction were screened to identify the patients with AIO. RESULTS AND DISCUSSION In this study total 60 no. of pt. were evaluated during the period of January 2017 to June 2018. From these 60 pts. 22 pts. managed conservatively where as 38 pts. were managed surgically. Overall mean age group of these pt. was 54 and M:F ratio was 1.3:1. Male has higher incidence than female .Among these pts. abdominal pain and vomiting are more common symptom than obstipation .Among this 60 patients, 20 patients had previous abdominal surgery, 16 patient had exploratory laparotomy for abdominal trauma , perforation, gynae procedure , appendicectomy, etc. 4 patient developed features of obstruction following laparoscopic T.L. among these 6 patients were managed conservatively and 14 patient undergo surgery. Mean duration for surgically managed was 2.8 days. Mean duration for conservatively managed patients was 2.9 days. Among the surgically managed pts. 14 had adhesions, 11 had stricture, 8 had obstructed hernia, 1 had intussusception, 4 had abdominal TB. Surgical procedures were done according to the cause of the obstruction. History of abdominal surgery was found to be more frequent in whom obstruction was relieved conservatively. CONCLUSION Adhesions due to previous surgery were found to be the most common cause of SBO. We were unable to accurately identify clear criteria for success of conservative v/s surgical management. None of the variable analyzed in this study were significant predictors for success of a particular line of treatment. The management of SBO and timing of surgical intervention continue to be governed by clinical decisions. Further study of methods for control and treatment of SBO is important because of its frequency, morbidity and cost in healthcare and patient’s disability

Keywords

obstruction, adhesion, dynamic obstruction, a dynamic obstruction.

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