Causes of Intestinal Obstruction in Erbil Teaching Hospital Province –North of Iraq
Iraqi Postgraduate Medical Journal,
2008, Volume 7, Issue 3, Pages 215-225
Bowel obstructions are not uncommon should be suspected in any patient with persistent vomiting, distention, and abdominal pain because delayed diagnosis and treatment can have devastating consequences. Undiagnosed or improperly managed obstructions can lead to vascular compromise, which causes bowel ischemia, necrosis, perforation, sepsis, and death.
The object of this study is to focus attention on the causes of intestinal obstruction and the role of abdominal radiographs and imaging in the diagnosis and operative procedures undertaken.
Setting: The study was conducted at the Department of Surgery, Erbil Teaching Hospital Erbil province (2.5 million populations) –Iraq, between years 1996 and 2005 inclusive.
A prospective study was carried out spread over 10-years, and involving 591 patients with intestinal obstruction, among them only 570 patients underwent operations included in this study and 21 patients with conservative management had been excluded.
Of the 570 patients with intestinal obstruction, 411were male patients (72.1%) their mean ages were 51.25% and 159 were female patients (27.9%) their mean ages was 39.8%.
The most common cause was the entrapment of bowel in an external hernia (30.7%). Postoperative adhesions accounted for obstruction in a third of our patients (28.7%), and (59%) of them followed appendectomy. The operative findings of all patients who presented obstructed hernias still account for the highest percentage of cases. Other minor causes constitute the rest of cases.
All 570 patients with the diagnosis of IO underwent surgical procedures in 68 patients (11.9%)who developed serious complications in the form of Sepsis, Intra-abdominal abscess, Wound dehiscence, Aspiration, Short-bowel syndrome (as a result of multiple surgeries)
Forty patients died (7%) mostly because of irreversible shock, pulmonary embolism, and multiorgan failure .
entrapment of bowel in an external hernia and adhesions remain the leading causes of acute intestinal obstruction in our environment. Sustained efforts at elective repair of hernias and research aimed at reducing adhesions are likely ways to reduce the high mortality from intestinal obstruction.
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