Abstract
Purpose: To find out the etiology and clinical findings of patients who were operated due to mechanical intestinal obstruction
Patients and Methods: A total of 68 patients operated for mechanical intestinal obstruction between 2001 and 2008 were studied retrospectively. Patients were evaluated with the medical history, physical examination, hemogram, biochemical tests, and abdominal Xray. The data about etiologies, clinical features, treatment modalities, morbidity and mortality rates were collected.
Results: There were 36 men (52.9 %) and 32 women (47.1 %). The location of obstruction was the small intestine in 83.8 % and the large bowel in 16.2 %. Abdominal wall hernias were the most common (52.9 %) cause of intestinal obstruction in this study. Adhesions (19.1%) and malign lesions (18%) were the other common pathologies. The most common postoperative complication was wound infection. Sepsis, multiorgan disfunction, ileus and pneumonia were other complications. Mortality occurred in 3 patients (4.3%).
Conclusion: Incarcerated abdominal wall hernias comprised the most common etiological factor in mechanical intestinal obstruction in our country. Figuring out the causes of morbidity and mortality will increase the success rates of the treatment.
Keywords:
Intestinal obstruction, strangulated hernia, adhesion
References
1Adesunkanmi ARK, Agbakwuru EA. Changing pattern of acute intestinal obstruction in tropical African population. East Afr Med J 1996; 11: 726-730.
2Fischer JE, Nussbaum MS, Chance WT, Luchette F. Manifestations of gastrointestinal disease. In: Schwartz SI, Shires GT, Spencer FC, Daly JM, Ficher JE, Galloway AC, eds. Principles of surgery, 7th ed. New York:McGraw Hill, 1999;1033-1079.
3Sufian S, Matsumoto T. Intestinal obstruction. Am J Surg 1975;130:9-14.
4Foster NM, McGory ML, Zingmond DS, Ko CY. Small bowel obstruction: a population- based appraisal. J Am Coll Surg 2006 ;203:170-176.
5Miller G, Boman J, Shrier I, Gordon PH. Etiology of small bowel obstruction. Am J Surg 2000;180:33-39.
6Uludağ M, Akgün İ, Yetkin G, Kebudi A, İr A, Şener A. Mekanik bağırsak tıkanıklıklarında morbidite ve mortaliteyi etkileyen faktörler . Ulus Travma Acil Cerrahi Derg 2004;10:177-184.
7Kebudi A, Işgör A, Kaya A, Yetgin G. Akut mekanik intestinal obstrüksiyon. Ulus Travma Acil Cerrahi Derg 1995;1:110-112.
8Hamaloğlu E, Yavuz B, Açıkgöz H. Mekanik intestinal obstrüksiyon: 1120 hastanın değerlendirilmesi. Turk J Gastroenterol 1991;2:69-74.
9Kağızman SH, Belviranlı M, Şahin M, Vatansev C, Karahan Ö, Alptekin H. Mekanik bağırsak tıkanıklığı nedeniyle acil ameliyat edilen hastaların klinik analizi. T Klin Tıp Bilimleri 1997; 17: 203.
10Akgün Y, Yılmaz G, Akbayin H. Causes and effectıve factors on mortalıty of ıntestınal obstructıon ın the South East Anatolıa. Turk J Med Sci 2002;32:149-154.
11Akcakaya A, Alimoglu O, Hevenk T, Bas G, Sahin M. Mechanical intestinal obstruction caused by abdominal wall hernias. Ulus Travma Acil Cerrahi Derg 2000; 6: 260-265.
12McEntee G, Pender D, Mulvin D, McCullough M, Naeeder S, Farah S, et al. Current spectrum of intestinal obstruction. Br J Surg 1987;74:976-980.
13Chen XZ, Wei T, Jiang K, Yang K, Zhang B, Chen ZX, et al. Etiological factors and mortality of acute intestinal obstruction: a review of 705 cases. Chin J Integr Med. 2008 ;6:1010-1016.
14Fuzun M, Kaymak E, Harmancioglu O, Astarcioglu K. Principal causes of mechanical bowel obstruction in surgically treated adults in Western Turkey. Br J Surg,1991; 78: 202-203,
15Richards WO, Williams LF. Obstruction of large and small intestine. Surg Clin North Am 1988;68:355-376.
16Gurel M, Alic B, Bac B, Keles C, Akgun Y, Boylu S. et al. Intraoperative colonic irrigation in the treatment of acute sigmoid volvulus. Br J Surg 1989;76: 957-958.
17Playforth RH, Holloway JB, Griffen WO. Mechanical small bowel obstruction: A plea for earlier surgical intervention. Ann Surg 1970;171:783-787.
18Zuidema GD, Nyhus LM. Shackelford's. Surgery of the Alimentary Tract. 4th ed. Philedelphia Pa :W. B. Saunders Co, 1996: pp.375-390.
19Fevang BT, Fevang JM, Stangeland L, Soreide O, Svanes K, Viste A. Complications and death after surgical treatment of small bowel obstruction: a 35- year institutional experience. Ann Surg 2000;231:529-537.
20Tondelli P, Kohler O, Harder F, Allgower M. Mechanical ileus: analysis following 360 operations. Schweiz Med Wochenschr 1983;113:561-564.
21Malangoni MA, Times ML, Kozik D, Merlino JI. Admitting service influences the outcomes of patients with small bowel obstruction. Surgery 2001;130:706-711.
22Da Silva G, Santos JC, Martins S, Giria J, Pereira CA. Intestinal obstruction. The experience of the emergency service of S. Jose Hospital 1981-1991. Acta Med Port 1994;7:155-163.