A comparative study of conservative and surgical management in intestinal obstruction

Abstract

Intestinal obstruction is a condition that disrupts the normal movement of intestinal contents, which may result from either a mechanical blockage or impaired intestinal motility without the presence of an obstructing lesion. Small bowel obstruction (SBO) is classified into three types: extraluminal, intrinsic, and intraluminal. This retrospective observational study examined patients who presented with this condition at the A&E department of the surgical unit. A total of 100 patients were included in the study, with 71 managed through conservative treatment and 29 undergoing surgical intervention. The most commonly reported symptoms were abdominal pain and vomiting. Among those who underwent surgery, the average hospital stay was 3.5 days, whereas for conservatively managed patients, the mean duration was 2.4 days. Surgical findings indicated that 2 had abdominal TB, 1 had intussusception, 6 had obstructed hernias, 6 had strictures, and 18 had adhesions. The choice of surgical procedure depended on the underlying cause of obstruction. Additionally, a history of prior abdominal surgery was more frequently observed among those whose obstruction resolved without surgical intervention. The study concludes that adhesions from previous surgical procedures are a significant cause of SBO. The two primary approaches to managing this condition are conservative treatment and surgical intervention, with the selection of a specific method depending on multiple patient-related factors and clinical judgment which plays a crucial role in determining the appropriate management strategy and the timing of surgical intervention.

Keywords: Intestinal Obstruction, Adhesions, Dynamic Obstruction.