Muhammad Saleem Shaikh, Kheo Ram Dholia, Shahid Hussain Soomro, Akleema Asad Abro, Saima Athar Shaikh, Sikandar Ali Shaikh.
Current spectrum of acute intestinal obstruction at CMC Larkana.
Med Channel Jan ;16(2):295-8.

OBJECTIVE: To determine the presentation, etiological pattern, management and outcome of acute intestinal obstruction in tertiary care hospital Larkana. DESIGN: Case series study. PLACE AND DURATION OF STUDY: This study was carried out at Surgical Unit- I, Chandka Medical College Teaching Hospital, Larkana, between January 2006 to June 2009, over a period of three and half years. PATIENTS AND METHODS: A total number of 120 patients with various patterns of mechanical intestinal obstruction were included while those with history of trauma and paralytic ileus were excluded. After adequate resuscitation all patients with persistent signs of strangulation were operated. All parameters were entered in specially designed proforma. Data analysis was done by using SPSS version 13. RESULTS: Among 120 patients, 72 were male and 48 were female, with ratio of 1.6:1. Their age ranged between 16 to 82 years (Mean 42.5 year). Abdominal pain( 93.3%) and distention (91%) were common symptoms, The commonest causes of intestinal obstruction were obstructed / strangulated external hernias (25.83%) and intestinal adhesions (23.33%), followed by ileocaecal tuberculosis (10.83%), colonic malignancy (13.83%) and large gut volvulus (13.83%). Postoperative complications were observed in 38 patients (31.67%) and wound infection was on the top (15.83%). Average hospital stay was 7.9 days. The mortality rate was 6.66%. CONCLUSION: External hernias, as a cause of intestinal obstruction is the commonest pattern of its presentation in developing countries, followed by adhesions and tuberculosis. Increasing the patients awareness will help to decrease the incidence of obstructed hernias significantly, because the single most important antecedent of a grave prognosis in intestinal obstruction / strangulation is late presentation.

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