Volume 26, Issue 130, December 2022

The importance of timely management: Large bowel obstruction - Aetiology and its outcomes

Mahesh Kalloli^1♦, Rahul Kenawadkar², Priyanka Gadvi³, Rhea Sarkari²

¹Department of Surgical Oncology, JN Medical College, KLE Academy of Higher Education & Research (Deemed University), JNMC Campus, Nehru Nagar, Belagavi-590010, Karnataka, India
²Department of General Surgery, JN Medical College, KLE Academy of Higher Education & Research (Deemed University), JNMC Campus, Nehru Nagar, Belagavi-590010, Karnataka, India
³Department of Anaesthesiology, JN Medical College, KLE Academy of Higher Education & Research (Deemed University), JNMC Campus, Nehru Nagar, Belagavi-590010, Karnataka, India

^♦Corresponding author
Department of Surgical Oncology, JN Medical College, KLE Academy of Higher Education & Research (Deemed-to-be-University), JNMC Campus, Belagavi-590010, Karnataka, India

ABSTRACT

Introduction: Large bowel obstruction (LBO) is one of the most frequent cases encountered by a surgeon in the emergency department. It accounts for 6.3% of all intestinal obstructions. In the acute setting, it often presents with abdominal distention, vomiting and constipation. This study aims to analyse clinical and aetiopathological features associated with large bowel obstruction and the outcome of various modalities of managing LBO. Patients and Methods: In this prospective study, patients above 18 years of age presenting to the emergency department of our hospital with features suggestive of dynamic intestinal obstruction were selected. After confirmation of the diagnosis and its underlying aetiology, they were managed either surgically or conservatively. The patient outcome in terms of complications and mortality were evaluated. Results: Out of 53 patients, 29 were males and 24 were females. The most common cause of large bowel obstruction was colonic malignancy in 27 patients (50.94%) followed by colonic volvulus in 15 patients (28.30%). Majority of patients (45) underwent surgery. The most common procedure done in our study was resection and anastomosis in 29 patients. 20% of the cases suffered from wound infection. Out of 53 cases in our study 27 patients had an uneventful post-operative period and 13 patients had delayed recovery. The total number of deaths in the study was 5 (12.5%). Conclusion: Prompt diagnosis and timely appropriate surgery in large bowel obstruction with available modern equipment and anaesthesia reduces morbidity, mortality, hospital stay and gives a satisfactory outcome.

Keywords: Obstruction, colonic malignancy, resection and anastomosis

Medical Science, 2022, 26, ms559e2536

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DOI: https://doi.org/10.54905/disssi/v26i130/ms559e2536

Published: 26 December 2022