Qureshi M I, Imran Anwar, Harun Majid Dar, Ashfaq Ahmad, Khalid M Durrani.
Managing small intestinal obstruction: A Sheikh Zayed Hospital experience.
Proceeding Shaikh Zayed Postgrad Med Inst Jan ;19(1):19-23.

Managing intestinal obstruction continuous to challenge surgeons allover the World. Between January 2001 to December, 2004, 54 patients with maw to female ratio of 1.8:1 and mean age of 51 presented with small bowel obstruction. They were divided in to two groups, group A and B. Group A comprised of 30 patients (55%) and were managed conservatively. Whereas group B had 24 patients (44%) who required surgery. Conservative management was observed for 12 to 36 hours and beyond this time patients were explored in the face of deterioration. In group A, 83% patients had history of previous surgery whereas 17% patients had no prior surgical intervention. In group B 38% patients had abdominal surgery in the past whereas 62% had no previous surgical intervention. Predominant symptoms of bowel obstruction were abdominal pain, (100%) constipation (60%) and vomiting (48%). Common causes of obstruction were post-operative adhesions 38% (n=7) obstructed hernias 25% (n=6) ileoceacal tuberculosis 21% (n=3) intestinal ischem ia 8% (n=2) and ceacal carcinoma 8% (n=2). Two patients died to septicemia, subsequent to anastomotic leak. We conclude that adhesive bowel disease and obstructive external hernias are the commonest causes of small bowel obstruction. A good clinical acumen and repeated clinical examinations are necessary to avoid the stage of bowel gangrene while managing small intestinal obstruction.

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