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A clinical study on the surgical management of intestinal obstruction

Intestinal obstruction remains one of the common emergencies encountered by general surgeons all over the world. Acute intestinal obstruction occurs when there is a disruption in the frontward flow of intestinal contents. This interruption can occur at any point along the length of the gastrointestinal tract, and clinical symptoms differ based on the level of obstruction. Causes often cited for the same include intra-abdominal adhesions, or obstructed hernias, causing an external compression over the bowel loops. The clinical picture variesthe patient may present with a stable, fair general condition complaining of only slight abdominal discomfort, or with features of hypovolemic, or septicaemic shock (or both, in some instances). 1,3,4,6,7 Presenting symptoms may include these cardinal features like nausea, vomiting, colicky abdominal pain, and failure to pass flatus or faeces. The characteristic examination findings of abdominal distension, tympanic note (on percussion) and hyperperistaltic bowel sounds (on auscultation) suggest the diagnosis. Radiologic imaging can confirm the diagnosis, or may serve as a valuable adjunct when the diagnosis is uncertain. Although plain abdominal radiography is often the initial study, computed tomography (CT) is recommended if the index of suspicion is high or if suspicion persists despite negative radiography. Management of uncomplicated intestinal obstruction includes fluid resuscitation with correction of metabolic derangements, intestinal decompression, and ABSTRACT