R T Kuremu1, G Jumbi. 1. Moi University Medical School, P.O. Box, 4606-30100, Eldoret, Kenya.
Abstract
BACKGROUND: Adhesions after abdominal and pelvic surgery are a major cause of intestinal obstruction in the western world and the pathology is steadily gaining prominence in our practice. OBJECTIVE: To determine the magnitude of adhesive intestinal obstruction; to determine the types of previous operations in patients who presented with adhesive intestinal obstruction; to determine the outcome of treatment; and to determine the factors affecting the overall management of adhesion-related intestinal obstruction. DESIGN: Retrospective descriptive study. SETTING: The Moi Teaching and Referral Hospital (MTRH) - Eldoret, Kenya. RESULTS: Ninety three patients were managed for adhesive intestinal obstruction. Of these, 57 were male and 36 were female. Abdominal distension, bilious vomiting, absolute constipation and abdominal pain were the main symptoms. Forty two (45%) patients were operated on, twenty five (59%) of them being operated on more than 72 hours after the start of the symptoms. Eight (9%) patients had ischaemic gut injury by the time of operation. Fluid therapy was inadequately administered in 86 (92%) patients, and their charts were not completely filled. CONCLUSION: Adhesion-related intestinal obstruction is a common problem encountered in the surgical service at the Moi Teaching and Referral Hospital-Eldoret. It is the major cause of intestinal obstruction. Fluid therapy and delayed surgical intervention were the major challenges in the management of these patients.
BACKGROUND: Adhesions after abdominal and pelvic surgery are a major cause of intestinal obstruction in the western world and the pathology is steadily gaining prominence in our practice. OBJECTIVE: To determine the magnitude of adhesive intestinal obstruction; to determine the types of previous operations in patients who presented with adhesive intestinal obstruction; to determine the outcome of treatment; and to determine the factors affecting the overall management of adhesion-related intestinal obstruction. DESIGN: Retrospective descriptive study. SETTING: The Moi Teaching and Referral Hospital (MTRH) - Eldoret, Kenya. RESULTS: Ninety three patients were managed for adhesive intestinal obstruction. Of these, 57 were male and 36 were female. Abdominal distension, bilious vomiting, absolute constipation and abdominal pain were the main symptoms. Forty two (45%) patients were operated on, twenty five (59%) of them being operated on more than 72 hours after the start of the symptoms. Eight (9%) patients had ischaemic gut injury by the time of operation. Fluid therapy was inadequately administered in 86 (92%) patients, and their charts were not completely filled. CONCLUSION: Adhesion-related intestinal obstruction is a common problem encountered in the surgical service at the Moi Teaching and Referral Hospital-Eldoret. It is the major cause of intestinal obstruction. Fluid therapy and delayed surgical intervention were the major challenges in the management of these patients.