Aetiology and Presentation of Intestinal Obstruction among Patients Presenting to a Tertiary Hospital in Uganda
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Date
2016
Journal Title
Journal ISSN
Volume Title
Publisher
Int J Crit Care Emerg Med
Abstract
Intestinal Obstruction is the impairment of normal
flow of intestinal contents from mouth to anal canal with aetiology
that varies depending on various factors. Understanding aetiology
of a country’s surgical services has proven to aid better planning
for its emergency surgical conditions. Mulago, which is Uganda’s
National Referral Hospital, is resource constrained with a surgical
burden of 33% due to acute abdomen with Intestinal Obstruction.
This study aimed to determine the current presentation pattern and
etiological factors of Intestinal Obstruction at Mulago.
Ethical approval was got, from Makerere
University School of Medicine IRB, to carry out a prospective
observational study among surgical patients admitted to Mulago
Hospital’s surgical wards and units. All patients admitted to the
hospital for the study period that fitted the inclusion criteria, with
suspected partial or complete Intestinal Obstruction or those with
confirmed diagnosis intraoperatively were consented and enrolled.
Results: We recruited 110 with 79 (71.8%) males and 31 (28.2%)
females. Paediatric patients of 0-12 years were 45 (41.0%) and 65
(59%) were adults above 13 years. We had 50% that presented
after 72 hrs of symptoms, 24.6% of these were initially managed
in a health centre and only 7.3% of the participants presented
within 24 hours. The commonest symptoms that presented were
colicky abdominal pain, vomiting, abdominal distension and relative
constipation. Hernias were the commonest cause of Intestinal
Obstruction in adults followed by gut volvulus then adhesions
and tumours while in the paediatric group had intussusceptions
as the most common aetiological factor followed by Anorectal
malformations and then congenital atresia plus stenosis as third
commonest cause of in children respectively.
Hernias followed by intestinal volvulus were the
commonest adult aetiology while intussusceptions followed by Anal
Rectal Malformations were the commonest paediatric aetiology of
intestinal obstruction. In Mulago hospital with colicky abdominal
pain, abdominal distension and vomiting as the commonest
presenting symptoms with males the predominantly affected sex.
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Citation
Nakanwagi, A. M., & Kijjambu, S. C. Peter Ongom (RIP), Luggya TS (2016) Aetiology and Presentation of Intestinal Obstruction among Patients Presenting to a Tertiary Hospital in Uganda. Int J Crit Care Emerg Med, 2, 018.