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Intestinal obstruction in a tertiary care centre in India: Are the differences with the western experience becoming less?

BACKGROUND: Patients with intestinal obstruction consist of a major proportion of emergency room visits and the complication is associated with a significant morbidity and mortality. It has a diverse aetiology which varies from country to country. In developed countries it is mainly due to adhesions...

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Autores principales: Jena, Suvendu Sekhar, Obili, Ravi Chandra Reddy, Das, Sri Aurobindo Prasad, Ray, Samrat, Yadav, Amitabh, Mehta, Naimish N., Nundy, Samiran
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8648950/
https://www.ncbi.nlm.nih.gov/pubmed/34925821
http://dx.doi.org/10.1016/j.amsu.2021.103125
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author Jena, Suvendu Sekhar
Obili, Ravi Chandra Reddy
Das, Sri Aurobindo Prasad
Ray, Samrat
Yadav, Amitabh
Mehta, Naimish N.
Nundy, Samiran
author_facet Jena, Suvendu Sekhar
Obili, Ravi Chandra Reddy
Das, Sri Aurobindo Prasad
Ray, Samrat
Yadav, Amitabh
Mehta, Naimish N.
Nundy, Samiran
author_sort Jena, Suvendu Sekhar
collection PubMed
description BACKGROUND: Patients with intestinal obstruction consist of a major proportion of emergency room visits and the complication is associated with a significant morbidity and mortality. It has a diverse aetiology which varies from country to country. In developed countries it is mainly due to adhesions and in developing countries due to obstructed hernias. Although there are numerous studies from the western world on this subject there have been few recent publications from the developing world. PATIENTS AND METHODS: We retrospectively analyzed all the patients admitted with intestinal obstruction to our department from January 1996 to December 2019. Their demographic data, duration of symptoms before presenting to the hospital and interval between admission and surgery were noted along with the cause and level of obstruction. The type of procedure, post-operative complications, mortality or whether re-exploration was done were also noted. Post-operative complications were graded according to the Clavien Dindo classification. RESULTS: A total of 986 patients presented with intestinal obstruction during this period out of which 743 patients underwent surgery. The commonest cause of obstruction was adhesions in 273 (36.7%) – the proportion increased significantly from 23% in 1996–2004 to 51.6% in 2013–2019. This was followed by carcinoma [130(17.5%)], tuberculosis [111(14.9%)], strictures [94(12.7%)] and hernia (5.4%). Colorectal surgery was the most common previous procedure in the adhesions group [85(31.1%)].The overall operative mortality was 41 (5.5%). CONCLUSION: The aetiology of intestinal obstruction in our hospital is now mainly due to adhesions and is thus shifting towards the western pattern. But tuberculosis and obstructed inguinal hernias still constitute of a sizable proportion of our patients.
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spelling pubmed-86489502021-12-17 Intestinal obstruction in a tertiary care centre in India: Are the differences with the western experience becoming less? Jena, Suvendu Sekhar Obili, Ravi Chandra Reddy Das, Sri Aurobindo Prasad Ray, Samrat Yadav, Amitabh Mehta, Naimish N. Nundy, Samiran Ann Med Surg (Lond) Cohort Study BACKGROUND: Patients with intestinal obstruction consist of a major proportion of emergency room visits and the complication is associated with a significant morbidity and mortality. It has a diverse aetiology which varies from country to country. In developed countries it is mainly due to adhesions and in developing countries due to obstructed hernias. Although there are numerous studies from the western world on this subject there have been few recent publications from the developing world. PATIENTS AND METHODS: We retrospectively analyzed all the patients admitted with intestinal obstruction to our department from January 1996 to December 2019. Their demographic data, duration of symptoms before presenting to the hospital and interval between admission and surgery were noted along with the cause and level of obstruction. The type of procedure, post-operative complications, mortality or whether re-exploration was done were also noted. Post-operative complications were graded according to the Clavien Dindo classification. RESULTS: A total of 986 patients presented with intestinal obstruction during this period out of which 743 patients underwent surgery. The commonest cause of obstruction was adhesions in 273 (36.7%) – the proportion increased significantly from 23% in 1996–2004 to 51.6% in 2013–2019. This was followed by carcinoma [130(17.5%)], tuberculosis [111(14.9%)], strictures [94(12.7%)] and hernia (5.4%). Colorectal surgery was the most common previous procedure in the adhesions group [85(31.1%)].The overall operative mortality was 41 (5.5%). CONCLUSION: The aetiology of intestinal obstruction in our hospital is now mainly due to adhesions and is thus shifting towards the western pattern. But tuberculosis and obstructed inguinal hernias still constitute of a sizable proportion of our patients. Elsevier 2021-12-02 /pmc/articles/PMC8648950/ /pubmed/34925821 http://dx.doi.org/10.1016/j.amsu.2021.103125 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Cohort Study
Jena, Suvendu Sekhar
Obili, Ravi Chandra Reddy
Das, Sri Aurobindo Prasad
Ray, Samrat
Yadav, Amitabh
Mehta, Naimish N.
Nundy, Samiran
Intestinal obstruction in a tertiary care centre in India: Are the differences with the western experience becoming less?
title Intestinal obstruction in a tertiary care centre in India: Are the differences with the western experience becoming less?
title_full Intestinal obstruction in a tertiary care centre in India: Are the differences with the western experience becoming less?
title_fullStr Intestinal obstruction in a tertiary care centre in India: Are the differences with the western experience becoming less?
title_full_unstemmed Intestinal obstruction in a tertiary care centre in India: Are the differences with the western experience becoming less?
title_short Intestinal obstruction in a tertiary care centre in India: Are the differences with the western experience becoming less?
title_sort intestinal obstruction in a tertiary care centre in india: are the differences with the western experience becoming less?
topic Cohort Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8648950/
https://www.ncbi.nlm.nih.gov/pubmed/34925821
http://dx.doi.org/10.1016/j.amsu.2021.103125
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