Abstract
CLINICAL STUDY AND EVALUATION OF SURGICAL MANAGEMENT OF ADULT PATIENTS WITH ACUTE INTESTINAL OBSTRUCTION

*Ismail Salih Hamam Al-Esawi, Khamis Yass AL-Qubaeissy and Qahtan Abed Hanash

ABSTRACT

This study aimed to evaluate the treatment protocol of intestinal obstruction in adults. In this cross-sectional study, A total of (40) patients diagnosed with intestinal obstruction in the OPD and emergency department of Al-Ramadi teaching hospital/Iraq were included during the period from July to December 2019. The ethical committee of the hospital was informed about the study and the ethical clearance certificate was obtained from them before the start of the study. All the patients with the provisional diagnosis of the intestinal obstruction were assessed clinically after the admission. Appropriate surgical procedures were implemented on the patients with clear signs and symptoms of acute abdominal obstruction. Surgery adopted and criteria for deciding the procedure were noted. Results showed that for the management of small bowl obstruction, Adhesiolysis was done to 9 patients, resection and anastomsis was done to 5 patients, to 3 patients the band release procedure was performed, hernia repair was done to 6 patients, followed by resection, hernia repair, volvulus derotation, while Mekels diverticulectomy was done to 1 patient respectively. For the management of large bowl obstruction, the colostomy was done to 6 cases, resection and anastomosis to 2 cases, intussusception milking to one case, volvulus derotation was done to 1 case and right hemicolectomy was done to 3 cases of CA ascending colon. It can be concluded from this study that success in the treatment of acute intestinal obstruction depends largely upon early diagnosis skillful management and treating the pathological effects of the obstruction just as much as the cause itself. Postoperative adhesions are the common cause to produce intestinal obstruction. Clinical radiological and operative findings put together can diagnose the intestinal obstruction. Mortality is still significantly high in acute intestinal obstruction.

Keywords: Adhesions, Intestinal obstruction, Large bowl, Small bowl, Treatment.


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