Prospective study of acute intestinal obstruction in adults based on etiology and severity indicators

Background: Intestinal obstruction is a common clinical entity in surgeons practice. In a large number of patient, therapeutic options are surgery versus conservative treatment; the choice of the treatment, that is, surgical versus conservative depends mainly on the surgeon’s assessment, and, therefore, is a clinical challenge to decide. Aims and Objectives: The purpose of our study is early detection of strangulated bowel obstruction based on a clinical, laboratory, and radiological parameters, a severity indicator score developed by combining these parameters. Materials and Methods: It was a hospital-based prospective observational study of 100 patients between April 2019 and October 2020 who presented with intestinal obstruction. Clinical, laboratory, and radiological parameters were noted and scoring was done as per severity scores. Results: Common cause of obstruction in this study was adhesions 41%, tuberculosis 13%, malignance 8%, and mesenteric ischemia 6% followed by intussusception and volvulus. Patients who had score <3 were managed conservatively, while 90.9% of patients having a score of three or more where operated on, which was statistically significant. Conclusion: Evaluation of the patient is not only to confirm the diagnosis but also timely management of strangulation and prevention of ischemia of gut to improve morbidity and mortality. This study used a severity scoring system of clinical parameters and laboratory and radiological investigation to help in the decision-making of treatment in a case of intestinal obstruction.