Abstract:
Background: Intestinal obstruction remains one of the most common surgical diagnoses made
in emergency departments worldwide [1]. Its magnitude and causes have kept changing over
time within various parts of country, varies from time to time and from area to area even in the
same country and affected by different factors.
Objective: -The objective of this study is to assess associated factor and management outcome
of adult intestinal obstruction patients managed operatively at Nekemte Referrals Hospital, from
January to September 2018.
Method: - Institution based cross-sectional study was conducted in Nekemte Referral Hospital,
Oromia region, Western Ethiopia from January to September 2018. Data was collected from
surgically managed adult patients who were admitted in Nekemte Referral Hospital surgical
ward with the diagnosis of intestinal obstruction. The data was collected directly from the
patient and from the patient’s card. The collected data checked for any inconsistencies,
incorrectness, and incompleteness. Then, data entered to epidata software and exported to SPSS
version 22.0 for data analysis. Data was analyzed and presented by frequency distribution and
logistic regression. On binary logistic regression analysis, a p-value <0.25 was used as a
reference to be a candidate for multivariable logistic regression analysis. P-Value<0.05 at 95%
confidence interval (CI) was considered as statistically significant.
Result: Totally, 206 surgically managed adult intestinal obstruction patients get admission from
January to October 2018. SBO accounts 126 (61.8%) and LBO 80 (38.2%). Patients’ age
ranges between 15-80 years with a mean of 42.66(SD±16.15) and M: F ratio of 1.4:1.
Independent factors that predict the management outcome were age, intra-operative finding and
anastomosis leak (see table 6). Overall mortality was 12.1%, which is mainly due to sepsis
19(76%) %. 44 (21.3%) patients developed postoperative complication.
Conclusion and recommendation: SBO was the leading site of obstruction caused by small
bowel volvules, inguinal hernia, and adhesion. Sigmoid volvules and colo-rectal mass were the
two most common causes of LBO. The mortality rate and postoperative complication were high
and needs careful peri-operative multidisciplinary patient evaluation and monitoring. Elective
surgery for inguinal and femoral hernia repair should be widely performed in NRH and its sub
region hospitals that have general surgeons.
