Etiology and Management Outcomes of Bowel Obstruction in Adults at The Delta State University Teaching Hospital, Oghara. Nigeria: a one-year prospective study
Keywords:
Etiology, Management, Outcomes, Adult intestinal obstruction, Oghara, Nigeria.Abstract
Background: Bowel obstruction is a common cause of admission in general surgical practice. Its causes vary regionally according to the country. The management outcomes dependent on several variables which may result in morbidity and mortality. This study focused on identifying the causes and management outcomes of adult bowel obstruction in a tertiary institution in southern Nigeria.
Methods: This prospective descriptive study was carried out from September 2022 to November 2023 at the Delta State University Teaching Hospital in Oghara. All consecutive patients who were 18 years of age and older who presented with features suggestive of bowel obstruction to the accident and emergency department of the institution or were referred to the general surgical unit from other units within the hospital were included. Patients’ biodata, resuscitative measures, treatment options and outcomes were documented and entered into a proforma sheet. SPSS version 25 was used to analyze the data.
Results: There were 33 patients with bowel obstruction. Eighteen (54.5%) were females and 15(45.5%) were males. The female to male ratio was 1.2:1. The presenting symptoms were vomiting 33 (100.0%), abdominal pain 33 (100.0%), abdominal distension 30 (90.9%) and constipation 30 (90.9%). A total number of 24 (72.7%) patients had small bowel obstruction while 9 (27.3%) patients had large bowel obstruction. Operative management was done in 30 (90.9%) cases. All the patients with large bowel obstruction were operated while 21 (70.0%) patients with small bowel obstruction were operated. The major indication for surgery was failed non-operative management for adhesive bowel obstruction in 14 (46.7%) patients.
The mean duration of hospital admission was 10.5±2.5 days versus 5.7 ± 1.2 days among operative and non-operative patients respectively. Surgical site infections (SSI) complicated 20% of patients who underwent surgery. There were no re-operations or mortalities.
Conclusions: Bands and adhesions constitute the major cause of bowel obstruction in our environment, followed by hernias. Outcome was good following early surgical intervention.
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