Determining the Relative Frequency of Intestinal Obstruction Causes in Patients Referred to Ahvaz Golestan Hospital During October 2003 to 2008
Abdolrahim Nahidi1* and Atefeh Ghosuri21Department of Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. 2School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Abstract: Intestinal obstruction is a disruption in the forward movement of intestinal contents which can mechanically or non-mechanically involve small and large intestine. Different structures from duodenum to the anal region can be partially or completely involved. Mechanical obstruction can be induced by obstructing agents in intestinal tract, intestinal wall or by the pressure of the intestine-outside factors on the intestinal wall. Non-mechanical obstruction can be induced by abdominal surgery, pneumonia, fractured vertebrae and ribs, renal colic, radiotherapy, diabetes and medicines and mesenteric artery thrombosis. The present study aimed to investigate the causes and frequency of intestinal obstruction in patients referred to Ahvaz Golestan Hospital during October 2003 to 2008. Research method: The medical records of patients diagnosed with intestinal obstruction were studied. Finally, having finished the treatment process, 214 patients were discharged and their records were investigated according to the study’s goals and questions. In this study, 15.65% of the patients voluntarily left the hospital, 2.84% died during the treatment process, and 76.15% (214 patients) were discharged from the Hospital. In the present study, 60.3% of the patients were males and 39.7% were females. The age group of 61-75 years was the most referred age group to the Hospital. Winter showed the highest number (29.5%) of referring patients, and abdominal pain, nausea and vomiting, inability to pass gas and anorexia were the most common symptoms of patients when referring to the hospital. Finally, the patients underwent surgery and non-surgery treatments in two groups, with 45.3% undergoing surgery and 54.7% responding to supporting therapies. In the surgery group, the site of obstruction of 77.3% was in the small bowel, and that of 22.7% was in the colon. The most common causes of intestinal obstruction in the patients were adhesion of bands (52.40%), fecal impaction (13.1%), ileus (9.8%), hernia (7.5%), colon tumor (6.5%), bowel ischemia and gangrene (4.2%), rectosigmoid tumor (3.7%), volvulus (2.3%), and bezoar (0.5%). In this study, the population of male patients with bowel obstruction was more than the females. The most common cause of bowel obstruction in the referring patients was shown to be adhesion bands. The most common reason that led to surgery was adhesion bands and the most common sign that responded to the Medical Treatment was also adhesion bands. The highest figure of surgery as well as that of medical treatment belonged to the age group of 61-75 years. The causes that led to ultimate surgery had nothing to do with time, but the highest response to the medical treatment was in winter.
Keywords: Intestinal Obstruction; Medical Treatment; Surgical Treatment; Small Bowel; Colon; Adhesion Bands; Fecal Impaction Back to TOC