Intestinal obstruction in AL-Hilla general teaching hospital, causes and incidence

Abstract

Background: The etiology of intestinal obstruction varies globally, with adhesions being the leading cause in developed countries, while hernias remain the most common cause in many developing nations. However, in some countries in Asia and Africa, adhesions have become the predominant cause. Strangulation obstruction increases mortality, necessitating immediate surgical intervention. This study aims to determine the frequency of various causes of intestinal obstruction and assess clinical criteria for diagnosing strangulation. Aim of the Study: To identify the most common causes of intestinal obstruction and their incidence at Al-Hilla General Teaching Hospital. Method: A cross-sectional, prospective study was conducted at Al-Hilla Teaching Hospital from September 2018 to September 2020. All patients diagnosed with acute intestinal obstruction were included. Data on patient demographics, clinical findings, cause of obstruction, management type, preoperative provisional diagnosis, and operative findings were recorded in a questionnaire. Results: A total of 103 patients were studied, with a male-to-female ratio of 2:1. The most common age group was the fifth decade (27.1%). The leading cause of obstruction was hernia (39.8%), followed by adhesions (34.9%) and tumors (13.5%). Inguinal hernia (56.1%) was the most common hernia type, followed by paraumbilical hernia (26.8%) and incisional hernia (14.7%). Laparotomy was the most frequent procedure for postoperative adhesions, followed by appendectomy and gynecological operations. There was a significant correlation between constant pain, localized tenderness, rebound tenderness, and leukocytosis with bowel strangulation. Conclusion: Hernias are the leading cause of intestinal obstruction. Early diagnosis and appropriate management reduce morbidity and mortality, and addressing preventable causes decreases the incidence of obstruction.