Mechanical Intestinal Obstruction Causes and Management

Abstract

aim:- Is to find out the possible cause or causes leading to intestinal obstruction and to encourage doctors to make use of their clinical abilities with few laboratory and radiological facilities available to diagnose and manage intestinal obstruction.Patients and Methods: The study consists of 73 patients admitted to AL-Hilla teaching hospital with intestinal obstruction from October 2006 to December 2007. Full medical assessment was done for them with full investigations. Thirty three patients needed surgical intervention.Results: The commonest etiology of intestinal obstruction was adhesions and bands 44 patients (60%), 5 patients (6.8%) incarcerated abdominal hernia, 3 patients (4.1%) Volvulus of sigmoid, 2 patients (2.7%) mesenteric thrombosis, 2 patients (2.7%) intuscessuption and 2 patients (2.7%) with pseudo obstruction. Small intestinal obstruction constitutes 61 cases (83.56%) and large bowel obstruction 12 patients (16.4%).Discussion: The results of this study indicates that postoperative adhesions and bands are the 'main cause of intestinal obstruction and appendicectomy was the main operation leads to adhesional intestinal obstruction followed by gynecological operation .It also indicates that generalized abdominal tenderness and rebound tenderness are significant indicator of bowel strangulation.Conclusion: Intestinal obstruction is a serious surgical condition and needs careful clinical history and examination which remains the corner stone by which we can differentiate between simple and ischemic obstruction, usually early intervention needed to prevent gangrene and decrease morbidity and mortality.