COMPARATIVE STUDY OF SIMPLE VERSUS STRANGULATING OBSTRUCTION OF THE SMALL BOWEL

Dr. Ajoy Kumar Kro; Dr. Likha Raju

Volume : VIII, Issue : VI, June - 2019

COMPARATIVE STUDY OF SIMPLE VERSUS STRANGULATING OBSTRUCTION OF THE SMALL BOWEL

Dr. Ajoy Kumar Kro, Dr. Likha Raju

Abstract :

Background and Objectives: The aim of present study has been conducted in the view of early diagnosis of strangulating obstruction and management of mechanical bowel obstruction in adult population in small-bowel obstruction and reduce an increased risk of morbidity and mortality for strangulating obstruction in our hospital. Methods: Sixty two patients underwent an emergency exploratory laparotomy because of acute small bowel obstruction between 1st, October, 2017 to 30th, September, 2018 in the surgery department of Assam Medical College, Diugarh, Assam. In present study, we examined the different clinical findings between simple obstruction and strangulation obstruction. Plain supine and upright abdominal radiographs, ultrasonography of abdomen and total leukocyte count were done in all patients. Results: All sixty two patients underwent exploratory laparotomy for acute small bowel obstruction. Thirty nine patients (62.9%) were simple obstruction and Twenty three patients (37.1%) were strangulating obstruction. Twenty two patients (56.41%) were male and seventeen patients (43.59%) were female for simple obstruction. Fifteen patients (65.23%) were male and eight patients (34.77%) were female for strangulating obstruction. Adhesions and bands (59.67%)was the most common cause of both simple and strangulating small bowel obstruction in present study,2,3. No mortality was recorded in simple obstruction but 7 patients expired in strangulating obstruction with mortality rate of 30.43%. Conclusions: All age groups were involved. Male patients dominated in both simple and strangulated small bowel obstruction. Pain abdomen was a chief complaint, followed by distension, vomiting and obstipation1,2,3,4,5,10. Classically, an intractable constant non-cramping abdominal pain, tachycardia, fever, white blood cell count >12, 000, /mm3, and abdominal tenderness with guarding and rigidity were predominant finding of strangulated obstruction.1,2,3,10. Plain X-ray abdomen2,3 and ultrasonography were important radiological tool. Etiology ranged from simple bands to malignant obstruction. Postoperative adhesions were the most common cause of obstruction2,3. A better the outcome was seen in the patients with earlier the presentation.