CLINICAL PRESENTATION AND MANAGEMENT OUTCOMES OF ACUTE INTESTINAL OBSTRUCTION AT A TERTIARY CARE CENTRE IN JODHPUR: A PROSPECTIVE OBSERVATIONAL STUDY
Main Article Content
Keywords
Acute intestinal obstruction; small bowel obstruction; adhesive obstruction; conservative management; surgical outcomes
Abstract
Acute intestinal obstruction remains one of the most common surgical emergencies, accounting for 15-20% of hospital admissions with acute abdominal pain. Understanding the local patterns of clinical presentation, etiological factors, and management outcomes is essential for optimizing patient care in tertiary care settings.
Methods: This prospective observational study was conducted at the Department of General Surgery, Vyas Medical College and Hospital, Jodhpur, from July 2024 to December 2024. A total of 140 adult patients presenting with clinical and radiological features of acute intestinal obstruction were enrolled through consecutive sampling. Data were collected using a structured proforma encompassing demographic details, clinical presentations, investigational findings, management strategies, and outcomes. Statistical analysis was performed using SPSS version 25.0 with appropriate descriptive and inferential tests.
Results: The mean age of participants was in the 46-60 years range with male predominance (63.6%). Small bowel obstruction constituted 74.3% of cases. The most common symptoms were abdominal pain (97.1%), vomiting (91.4%), and abdominal distension (84.3%). Postoperative adhesions were the leading etiology (41.4%), followed by obstructed hernias (18.6%) and malignancy (14.3%). Conservative management was initially attempted in 55.7% of patients with 59% success rate. Overall, 67.1% required surgical intervention. The complication rate was 27.1%, with surgical site infection being most common (11.4%). The overall mortality rate was 6.4%, with mean hospital stay of 5.2±2.1 days for conservative management and 10.8±4.3 days for surgical cases.
Conclusion: Acute intestinal obstruction predominantly affects middle-aged males, with adhesions and hernias being the primary etiologies. Judicious patient selection for conservative management and timely surgical intervention are crucial for optimal outcomes.
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Dr Shyam Sunder Vaishnav
Assistant Professor, Department of General Surgery, Vyas Medical College and Hospital, Jodhpur, Rajasthan, India.
