A clinical study and surgical management of acute large bowel obstruction

Background: Acute large bowel obstruction is one of the most common surgical emergencies associated with high mortality and morbidity. The clinical symptoms may vary based on the level of obstruction. A careful clinical examination and judicious investigations are essential in the management of acute large bowel obstruction. Aim: The aim of this article is to study epidemiology, clinical features, radiological investigations, surgical procedures, and outcome in patients with acute large bowel obstruction. Methodology: This prospective study was conducted on patients with acute large bowel obstruction admitted in the General Surgery Department, DR. PSIMS and RF from October 2020 to December 2022. Results: In our study of 60 patients with acute large bowel obstruction, most of the cases were reported in the sixth decade and had a high male preponderance (2:1). All cases presented with pain abdomen and 90% of patients had distension. Computed tomography was the imaging method of choice as it can establish the diagnosis and causes of large bowel obstruction. Colorectal malignancy (48.33%) was the commonest cause of acute large bowel obstruction followed by sigmoid volvulus (33.33%). Loop colostomy (40%) was the most common procedure done followed by Hartmann’s procedure (26.67%). The postoperative mortality rate was 6.67%. Conclusion: In our study, colorectal malignancy was the most common cause of acute large bowel obstruction. Loop colostomy was the most common surgery performed with minimal complication rate. A careful assessment, awareness, and expertise in current modalities of the treatment for acute large bowel obstruction were required for optimal surgical management.