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ORIGINAL ARTICLE
Year : 2019  |  Volume : 17  |  Issue : 3  |  Page : 49-54

A prospective study to determine the clinical profile of patients suspected to have acute intestinal obstruction in the emergency department


1 Department of Emergency Medicine, Christian Medical College, Vellore, Tamil Nadu, India
2 Department of General Surgery, Christian Medical College, Vellore, Tamil Nadu, India

Correspondence Address:
Dr. Kundavaram Paul Prabhakar Abhilash
Department of Emergency Medicine, Christian Medical College, Vellore - 632 004, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cmi.cmi_19_19

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Background: Acute intestinal obstruction (AIO) is a surgical emergency, with its varied symptomatology and presentation, and diagnosing it is always a challenge to the emergency physician. This study was done to understand the prevalence, various etiologies, usefulness of computerized tomography (CT) of the abdomen in the diagnosis, rate of surgical management, and outcome of AIO in the emergency department (ED). Materials and Methods: This prospective study included all the patients who presented to the ED with a history of inability to pass stools and flatus and diagnosed to have intestinal obstruction clinically. This study was conducted for a duration of 6 months (December 2017–May 2018). Patient's clinical parameters, radiological imaging, etiology, treatment given, and outcome of the patients were noted. Results: Among 15,857 patients who presented to the ED over a study period, 90 (0.567%) patients had AIO out of 120 suspected cases. The most common age group (22%) was more than 60 years of age with female preponderance (55.6%). Most common etiological factor was adhesion (26.67%), followed by hernia (23.3%). Among 120 suspected patients, those who had undergone CT abdomen (n = 59) showed 95.6% of sensitivity, 100% of specificity, and 96.6% of accuracy in comparison with abdomen X-ray and ultrasonography abdomen. Forty-two (46.7%) patients diagnosed with AIO were operated, while 32 (35.6%) patients were managed conservatively and the remaining 16 (17.8%) patients were discharged against medical advice. The mortality rate among the operated patients was 2.7% (n = 2). Conclusion: In the ED, women in their sixties were the one who most commonly presented with AIO. The most common cause of admission with AIO was adhesions. CT abdomen is an accurate modality for diagnosing AIO.


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