Assessment of Etiology and Treatment Outcome Of Adult Patients with Large Bowel Obstruction At Jimma University Medical Center, January 2022 Jimma, Ethiopia

Abstract

Background: Intestinal obstruction (IO) occurs due to the failure of propagation of intestinal contents and classify into large bowel & small bowel obstruction. As a part of IO, complete LBO is an abdominal emergency, which has high morbidity, and mortality rates if not treated. Because of limited number of study in this area, I need to conduct the study on this topic. Objective: To study the etiology and treatment outcome of adult patients with the diagnosis of large bowel obstruction admitted and managed during six months study period at jimma. University medical center Methods: Hospital-based cross-sectional study was used. Study subjects were all adult patients visiting jimma university medical center with diagnosis of large bowel obstruction, admitted, and managed. The study was conducted between July 1, 2021 to December 31, 2021 at JUMC. Source of data was from patient and medical records of patients who were admitted to surgical department with diagnosis of large bowel obstruction during stated study period. Trained data collectors collected data using a pre-tested questionnaire. Data was entered and analyzed using SPSS software (version 26). The result is presented using charts, tables, and graphs and described using texts. Result: During stated study period total of 50 adult patients were diagnosed and managed for large bowel obstruction at JUMC. Of which 39 patients were males (78%), 11 patients were females (22%) with M: F ratio of 3.5:1. The most common cause of large bowel obstruction was colonic volvulus 25(50%), followed by colorectal tumor 13(26%). The ultimate treatment for all patients was surgery, primary resection and anastomosis was the most commonly performed procedure. Fifteen (30%) patients developed complications after surgery, Hospital acquired infection was the leading complication occurred in 8(30%) patients, followed by SSI 4 (8%) patients. Death occurred in 7 patients with a mortality rate of 14%. High mortality was due to presence of shock at presentation, gangrenous bowel and presence of post op complications. Conclusion: Sigmoid volvulus was leading cause of LBO. High mortality is due to presence of shock at presentation, gangrenous bowel and presence of post op complications.