Magnitude, causes and management outcome of small bowel obstruction at metu karl referral hospital, oromia region, south western Ethiopia

Abstract

Background: Small bowel obstruction is defined as any hindrance to the passage of small intestinal contents. It is one of the common causes of surgical emergencies which result high morbidity and mortality globally. The causes of small bowel obstruction vary from region to region, as well as from season to season. Poor clinical judgment is one of the negative factors leading to poor prognosis in case of small bowel obstruction. Objective: To assess the magnitude, causes and management outcome of small bowel obstruction at Metu Karl referral hospital, from February 2017 to August 2017. Method: Hospital based prospective, cross sectional study design was conducted at Metu Karl referral hospital, from February 2017 to August 2017. Descriptive and inferential statistics were used. Binary logistic regression analysis was used from inferential statistics. Results: 81 of small bowel obstruction causes (3:1 Male to female ratio) were analyzed. The age ranges from 1 to 65 years with a mean age of 28.81 and + SD of 13.5years. The magnitude of small bowel obstruction among intestinal obstruction was 62.3%. The most common cause was small bowel volvulus 40.7% (n=33), followed by adhesion (commonly postoperative adhesion) 14.8% (n=12). Gangrenous bowel has significant statistical association with management outcome (AOR= 4.1, 95% CI: 2.9-8.0, p-value=0.018). Mean hospital stay in this study was 6.2days which ranges from 3-12 days. There were 2.4 %( n=02) deaths among small bowel obstruction. Conclusion and recommendation: Small bowel volvulus was the leading cause of small bowel obstruction followed by small bowel volvulus. Duration of illness before surgical intervention has significant statistical association with management outcome of patients (AOR=0.01, 95%CI: 0.005-0.619, p-value=0.019). Gangrenous bowel has four times risk of developing unfavorable outcome as compared with patients without gangrenous bowel. Early diagnosis, adequate preoperative resuscitation and proper post-operative care would help to reduce further mortality. This could be achieved by increase public awareness on health seeking behavior. Moreover, health facilities capable of handling patients with small bowel obstruction should be available within the reach of the community.