July 2016 Vol. 4 No.7

Search Pubmed for articles by:
 

Original Research Article

Adult intestinal obstruction: Risk factors and management

S. P. Agbo^* and M. Oboirien

Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

*Corresponding Author’s E-mail: agbostephen@yahoo.com

Accepted June 17, 2016

Abstract

Intestinal obstruction is among the common surgical emergencies presenting to the accident and emergency unit of hospitals worldwide. Etiologic factors vary widely among different regions depending on the part of bowel involved. Management also depends largely on the etiology and bowel segment involved. Not much work has been done to elucidate the risk factors for intestinal obstruction in our environment even though the condition presents commonly to our emergency department. In this study we looked at the risk factors for intestinal obstruction among adults and its management in patients presenting to a tertiary hospital in Sokoto, Nigeria. A 3 year retrospective study in which the case note of all patients that presented with intestinal obstruction to the Accident and Emergency department between 2012 and 2014 were retrieved and reviewed. A total of 48 patients were seen. Out of this, 70.83% (34) were males and 29.17% (14) were females, giving a male: female ratio of 2.4:1. The Mean age was 40.75 years while the Median age was 35 years. The peak age group of at risk was 30 – 39 years. Obstructed hernia was the leading cause of intestinal obstruction at 47.92% (23) followed by post- operative adhesions at 14.58% (7). Colo-rectal cancer was the third commonest cause of intestinal obstruction and the leading cause of large bowel obstruction at 10.42% (5) followed by typhoid ileal perforation and faecal impaction at 6.25% (3) each. Intussusception and metastatic ileal obstruction followed at 4.17% (2) each. Sigmoid volvulus and gunshot peritonitis were at 2.08% (1) each. Herniorrhaphy was the most frequently performed surgery at 47.91% (23) followed by exploratory laparotomy and conservative management at 20.84%(10) each; colostomy was performed in 10.41%(5) of patients. Wound infection was the commonest post -operative complication at 28.95%(11), followed by enterocutaneous fistula, 7.89%(3), wound dehiscence, 5.26%(2) and recurrent inguinal hernia, 2.63%(1). The overall mortality was 12.5%(6). Obstructed hernia remains the leading cause of small bowel obstruction followed by post–operative adhesions while colorectal cancer was the commonest cause of large bowel obstruction followed by faecal impaction.

Keywords: Hernia, Intestinal obstruction, Large bowel, Small bowel