Etiologies, patterns and management outcomes among adult patients with intestinal obstruction: a 5 years’ retrospective observation at a regional referral level hospital, Eastern Zone, Tanzania

Abstract

Background: Despite having centuries of existence, intestinal obstruction is still the commonest culprit among the existing causes of surgical admissions especially on emergency bases. Its persistence and piling up nature of the risk factors with the untoward management outcomes are great concerns considering the negative impacts brought down to the individual and the existing health care system. Methods: This was a retrospective hospital based observational study of patients with intestinal obstruction for over a period of five years from January 2015 to January 2020. A standardized checklist was used to secondarily collect data from the health management information system (HMIS) books. We relied on the descriptive statistics, univariate analysis was done to check for statistical association to the outcomes of interest. Results: We enrolled 423 patients, 23 excluded as per criteria and 400 recruited for the study. Males were more than females at a ratio of 2:1 with the mean age of 45 years (16 SD). Obstructed or strangulated abdominal wall hernia was the commonest etiology (43.4%) followed by intraperitoneal adhesions (22.1%). Patient’s age, diagnosis and management modality all influenced occurrence of the outcomes of interest with the p values of 0.03, 0.04 and <0.001 respectively. Conclusions: Most patients in our study had complicated abdominal wall hernia followed by intraperitoneal adhesions. Given their modifiability, we recommend for an early elective intervention to patients with abdominal wall hernia but also encouraging the use of all necessary adhesion prevention strategies in all abdominal and pelvic surgeries.