Abstract: Background: The etiology of
intestinal obstruction varies globally, with adhesions being the leading cause
in developed countries, while hernias remain the most common cause in many
developing nations. However, in some countries in Asia and Africa, adhesions
have become the predominant cause. Strangulation obstruction increases
mortality, necessitating immediate surgical intervention. This study aims to
determine the frequency of various causes of intestinal obstruction and assess
clinical criteria for diagnosing strangulation.
Aim of the Study: To identify the most
common causes of intestinal obstruction and their incidence at Al-Hilla General
Teaching Hospital.
Method: A cross-sectional, prospective study was conducted
at Al-Hilla Teaching Hospital from September 2018 to September 2020. All
patients diagnosed with acute intestinal obstruction were included. Data on
patient demographics, clinical findings, cause of obstruction, management type,
preoperative provisional diagnosis, and operative findings were recorded in a
questionnaire.
Results: A total of 103 patients were studied, with a
male-to-female ratio of 2:1. The most common age group was the fifth decade
(27.1%). The leading cause of obstruction was hernia (39.8%), followed by
adhesions (34.9%) and tumors (13.5%). Inguinal hernia (56.1%) was the most
common hernia type, followed by paraumbilical hernia (26.8%) and incisional
hernia (14.7%). Laparotomy was the most frequent procedure for postoperative
adhesions, followed by appendectomy and gynecological operations. There was a
significant correlation between constant pain, localized tenderness, rebound
tenderness, and leukocytosis with bowel strangulation.
Conclusion: Hernias are the
leading cause of intestinal obstruction. Early diagnosis and appropriate
management reduce morbidity and mortality, and addressing preventable causes
decreases the incidence of obstruction.
