CLINICAL PROFILE, ETIOLOGICAL SPECTRUM, AND MANAGEMENT OUTCOMES OF INTESTINAL OBSTRUCTION: A PROSPECTIVE OBSERVATIONAL STUDY AT A TERTIARY CARE HOSPITAL IN BIHAR

Abstract

Background: Intestinal obstruction is one of the most frequently encountered surgical emergencies and remains a major cause of morbidity and mortality worldwide. The clinical presentation, underlying etiology, and outcomes vary according to geographical location, healthcare accessibility, and patient characteristics. Early diagnosis and timely management are crucial for preventing complications such as bowel ischemia, perforation, sepsis, and death.

Objectives: To evaluate the clinical profile, etiological spectrum, management strategies, and treatment outcomes of patients presenting with intestinal obstruction at a tertiary care hospital in Bihar.

Methods: A prospective observational study was conducted in the Department of General Surgery of a tertiary care hospital in Bihar from February 2005 to June 2005. Thirty-six consecutive patients aged 18 years and above with clinically and radiologically confirmed intestinal obstruction were included. Data regarding demographic characteristics, presenting symptoms, etiological factors, treatment modalities, postoperative complications, and outcomes were collected using a structured case record form. Statistical analysis was performed using SPSS version 11.0. Categorical variables were expressed as frequencies and percentages, while appropriate statistical tests were used for comparison. A p-value <0.05 was considered statistically significant.

Results: A total of 36 patients were studied. The mean age was 45.8 ± 15.2 years, and males constituted 66.7% of cases. Abdominal pain was the most common presenting symptom, followed by vomiting, abdominal distension, and constipation. Postoperative adhesions (30.6%) were the leading cause of intestinal obstruction, followed by obstructed or strangulated hernias (25.0%), intestinal tuberculosis (13.9%), and malignancy (11.1%). Surgical management was required in 72.2% of patients, whereas 27.8% were managed conservatively. Overall recovery was achieved in 91.7% of patients. Postoperative complications occurred in 22.2% of patients, and mortality was observed in 8.3%. Delayed presentation beyond 48 hours was significantly associated with a higher incidence of postoperative complications (p=0.02).

Conclusion: Postoperative adhesions and obstructed hernias were the predominant causes of intestinal obstruction in the study population. Most patients required operative management and achieved favorable outcomes. Delayed presentation was associated with increased postoperative morbidity, underscoring the importance of early diagnosis, timely referral, and prompt surgical intervention for improved patient outcomes.