Gandikota Venkata Prakash1, G. Purushotham2, K. Ajay Babu3, Mamgunta Sai Anugna4, Mundlapudi Jahnavi5, Voleti Puneetha6
BACKGROUND
Intestinal obstruction can be defined as the partial or complete blockage of either
the small intestine or large intestine or both, causing failure of intestinal contents
to pass beyond the point of obstruction. Subacute intestinal obstruction implies
incomplete obstruction. It is characterized by continuous passage of flatus and /or
feces beyond 6 -12 hours of the onset of symptoms. We wanted to study the
conservative management of subacute intestinal obstruction and its outcome.
METHODS
Data was collected from patients presenting to outpatient Department of General
Surgery, SVRRGGH, Tirupati and emergency with the features of subacute
intestinal obstruction during the period of March 2019 to April 2020 were included
in the study.
RESULTS
The incidence is high in patients of age group 41-50 years with Male: Female ratio
is 2.1:1. The most common presenting symptom is pain abdomen (92 %), followed
by vomiting (84 %). In our study, exaggerated bowel sounds (60 %) are the most
common physical finding. The most common cause of obstruction is Postoperative
adhesions (36 %), followed by obstructed hernias (22 %). Out of 50 cases, 72 %
of cases were managed successfully by conservative management. In the patients
who were managed conservatively, most of them are due to postoperative
adhesions. In the patients who underwent emergency surgical intervention, 50 %
of cases operated on the 2nd day of admission. Most commonly done Surgery
include Adhesiolysis (28.6 %), Herniorrhaphy (28.6 %) and Resection and
anastomosis (21.5 %).
CONCLUSIONS
Our study showed that conservative management is successful in about 72 % of
patients with subacute intestinal obstruction. Not all the patients attending the
emergency ward with features of intestinal obstruction need emergency surgical
intervention. Conservative management can be tried in selective cases in patients
with SAIO, thereby reducing the rate of negative laparotomies and morbidity and
mortality.
