Causes and Effective Factors on Mortality of Intestinal Obstruction in the South East Anatolia

Authors: YILMAZ AKGÜN, GÜLŞEN YILMAZ, HASAN AKBAYIN

Abstract: Mechanical intestinal obstruction is a common problem confronting the surgeon. The clinical records of 699 patients surgically treated for intestinal obstruction were evaluated retrospectively and factors affecting mortality in these patients were investigated. There were 202 (28.9%) women and 497 (71.1%) men, with a median age of 48.5±19.4 years involved in the study. Volvulus formed the vast majority of cases (28.6%), followed by adhesions (25.3%), strangulated hernias (24.0%) and malignancy (16.8%). Although strangulated hernias and malignancy might occur at any age, the peak incidence for causes of obstruction due to adhesions (55.9%) was in the 15-34 age group, and volvulus (64.0%) in the 55-74 age group. Average duration of obstruction symptoms was 31.8 ± 7.2 hours (range 1-7 days). Strangulated hernias had the shortest duration of symptoms, whereas malignant obstruction had the longest. Strangulation was seen in 221 patients and, it occurred frequently in patients with volvulus (60.0%); however, the incidence of strangulation was lower in intra-abdominal malignancy (13.5%). The overall mortality rate was 10.4%, with a 7.7% mortality rate in patients with simple obstruction, and 16.2% in patients who had strangulation. The common causes of mortality were cardio-pulmonary failure in the 55-84 age group and septicemia in the 15-54 age group. In conclusion, the causes of mechanical intestinal obstruction seem to vary according to geographic area and age group. Therefore, physicians should be vigilant as a result of immigration and freedom of travel between countries. All patients with complete intestinal obstruction who were particularly thought to be suffering from strangulated obstruction were subjected to early surgical exploration following rapid resuscitation. The presence of strangulation, duration of symptoms and old age are factors affecting mortality.

Keywords: Mechanical intestinal obstruction, volvulus, strangulation, mortality

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