Ohene-Yeboah M, Adippah E, Gyasi-Sarpong K
Department of Surgery, Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, University Post Office, Kumasi, Ghana.
Ghana Med J. 2006 Jun;40(2):50-4. doi: 10.4314/gmj.v40i2.36017.
To describe the causes of acute intestinal obstruction in Kumasi and highlight the associated morbidity and mortality.
A proforma based prospective study.
The study was conducted at the Department of Surgery, Komfo Anokye Teaching Hospital Kumasi, Ghana, from January 1998 to December 2003 inclusive.
All consecutive adult patients admitted to the surgical emergency ward with a clinical diagnosis of acute intestinal obstruction, strangulated hernia, volvulus and intussusceptions were included in the study. Patients diagnosed as incarcerated or irreducible hernia were excluded.
Strangulated external hernias 412 (63.2%), and post- operative adhesions 176 (27.2%) accounted for nearly (90.4%) of the 652 cases. All other causes of obstruction including volvolus, neoplasia, strictures and intussusceptions accounted for less than 10% of the patients. Five hundred and eighty - one patients were operated upon and nearly half (242) required bowel resections with an overall mortality of 12 %. Compared with previous reports, adhesive obstructions are increasing whiles strangulated hernias are decreasing.
Strangulated external hernias and adhesions remain the leading causes of acute intestinal obstruction in our environment. Sustained efforts at elective repair of hernias and research aimed at reducing adhesions are likely ways to reduce the high mortality from acute intestinal obstruction.
描述库马西急性肠梗阻的病因，并强调其相关的发病率和死亡率。
基于表格的前瞻性研究。
该研究于1998年1月至2003年12月在加纳库马西的科姆福·阿诺克耶教学医院外科进行。
所有因临床诊断为急性肠梗阻、绞窄性疝、肠扭转和肠套叠而入住外科急诊病房的成年连续患者均纳入研究。诊断为嵌顿性或难复性疝的患者被排除。
652例病例中，绞窄性外疝412例（63.2%），术后粘连176例（27.2%），占近90.4%。所有其他梗阻原因，包括肠扭转、肿瘤、狭窄和肠套叠，占患者的比例不到10%。581例患者接受了手术，近一半（242例）需要肠切除，总死亡率为12%。与以前的报告相比，粘连性梗阻在增加，而绞窄性疝在减少。
在我们的环境中，绞窄性外疝和粘连仍然是急性肠梗阻的主要原因。持续努力进行择期疝修补术和开展旨在减少粘连的研究，可能是降低急性肠梗阻高死亡率的途径。
