A Clinico-Morphological Study of Intestinal Obstruction Cases with Radiological Co-relation

Introduction: Intestinal obstruction is a frequent surgical emergency. Effective management depends upon early and accurate diagnosis. If the diagnosis is unclear than essential laboratory test is needed .in recent years, radiological imaging methods have been used frequently in diagnosis to improve diagnostic accuracy, histopathological examination of resected intestine is expected to provide the definite evidence of the underlying etiology- guiding a better health care planning for preventive measures. Aims and objectives: To determine the frequency of intestinal obstruction and to find its etiology with the help of various investigations modalities. To study the role of specific severity indicators and their importance in early diagnosis and management. Material and methods: A two-year prospective observational study was conducted in Subharti medical college Meerut, for patients with clinical manifestation of intestinal obstruction. 60 patients were taken and their severity scores were calculated based on which further management was planned. Results: Mean age of patients in our series was 46.9 years. In our study pain abdomen was present in 95% patients followed by - obstipation (55%) and vomiting (38.3%).Abdominal distension was the most predominant physical finding (88.3%) followed by tenderness (78.3%) and guarding (33.3%) on CT the most common site of obstruction with surgical correlation was ileum. The commonest cause of intestinal obstruction in adults in this study series was adhesions in 21.7% cases. The most common surgery performed was exploratory laparotomy with resection anastomosis in 16 (40%) of operated cases. 87 % patients having a score less than 3 were managed conservatively, 100% having a score of 3 or more where operated on. Conclusion: This study tries to use a severity scoring system to help identify the ideal time to intervene in a case of intestinal obstruction. Most of the severity indicators have been found to be useful.