Clinical study of adhesion obstruction at a tertiary care hospital: a prospective observational study

Iqbal Saleem Mir; Younis Bashir; Yaser Hussain Wani; Younis Dar; Shiwani Thakur; Farzanah Nowreen; Syed Aadil Andrabi; Anees Khanday

doi:10.18203/2349-2902.isj20211298

Authors

Iqbal Saleem Mir Department of Surgery, Government Medical College, Srinagar, Kashmir, Jammu and Kashmir, India
Younis Bashir Department of Surgery, Government Medical College, Srinagar, Kashmir, Jammu and Kashmir, India
Yaser Hussain Wani Department of Surgery, Government Medical College, Srinagar, Kashmir, Jammu and Kashmir, India
Younis Dar Department of Surgery, Government Medical College, Srinagar, Kashmir, Jammu and Kashmir, India
Shiwani Thakur Department of Surgery, Government Medical College, Srinagar, Kashmir, Jammu and Kashmir, India
Farzanah Nowreen Department of Surgery, Government Medical College, Srinagar, Kashmir, Jammu and Kashmir, India
Syed Aadil Andrabi Department of Surgery, Government Medical College, Srinagar, Kashmir, Jammu and Kashmir, India
Anees Khanday Department of Surgery, Government Medical College, Srinagar, Kashmir, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2349-2902.isj20211298

Keywords:

Abdominal pain, Acute intestinal obstruction, Post-operative adhesion

Abstract

Background: Adhesion obstruction is one of the most common presentations of acute abdomen and an important cause of general surgical consultation. This study aimed to analyse demographic features, clinical features, predisposing factors, and management of this surgical problem.

Methods: The present study was a prospective observational study and was conducted in the Department of General Surgery of SMHS hospital entitling 267 patients who were diagnosed and treated over 5 years from May 2014 to April 2019.

Results: The most common age group diagnosed with acute intestinal obstruction was between 31 to 40 years, with the incidence more in males (65.5%) as compared to females (34.4%). The most common clinical feature was abdominal pain (98.1%) followed by vomiting (93.6%), constipation (86.1%) abdominal distension (82.3%). Postoperative adhesions (40.07%) followed by obstructed hernias (23.3%) and malignancies (14.6%) were the most common predisposing factors. Ischemia was the most common complication in 11.2% of patients followed by necrosis at 6.7% and perforation at 2.9%. Adhesiolysis was the most common surgical procedure performed 43.8% followed by anatomical repair 21.7% and resection and end to end anastomosis 15.3%, enterotomy 10.86%, and Hartman’s procedure 8.2%.

Conclusions: Adhesive intestinal obstruction is an important surgical emergency. Post-operative adhesions remain the most common cause of acute intestinal obstruction, with patients most commonly presenting with pain abdomen, all necessary steps must be taken to lessen the chances of adhesions after any surgical procedure.

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