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急性小肠梗阻:尼日利亚中北部联邦医疗中心常见病因和治疗方法评估。

Acute Small-bowel Obstruction: An Appraisal of Common Etiology and Management at the Federal Medical Centre, Keffi, North-central Nigeria.

机构信息

Department of General Surgery, Federal Medical Centre, Keffi, Nassarawa State, Nigeria.

Department of General Surgery, University of Abuja Teaching Hospital, Gwagwalada, Nigeria.

出版信息

Ann Afr Med. 2024 Jul 1;23(3):313-316. doi: 10.4103/aam.aam_111_23. Epub 2024 Jul 20.

Abstract

BACKGROUND

Acute small intestinal obstruction is a common surgical emergency in the sub-Saharan region. Over the decades, complicated inguinal hernias have been identified as a leading cause. However, we observed from our clinical practice that complicated inguinal hernias were not the most common etiology.

AIMS AND OBJECTIVES

This study aimed to evaluate the common etiology of acute small bowel obstruction in the study center and compare our findings with that from other centers and existing literature.

MATERIALS AND METHODS

This was a retrospective, cross sectional study carried out over a period of five years (January 2017 to December 2021). This study looked at the patients presenting with acute, mechanical, small bowel obstruction that did not respond to conservative treatment in our hospital facility. Relevant information were extracted from patients' clinical details and entered into the proforma prepared for this study.

RESULTS

A total of 147 patients were recruited into this study out of which 85(57.8%) were males and 62 (42.2%) were females (M:F=1.44:1). Majority (80.3%) of the patients that presented with post-operative bowel adhesion had previous appendectomy. Simple bowel obstruction was seen in 93 (63.3%) patients while strangulated obstruction and gangrenous bowel were seen in 26 (17.7%) patients and 22 (15.0%) patients respectively. Majority (47.6%) of the patients had adhesiolysis done while others had bowel resection.

CONCLUSION

The common cause of acute small bowel obstruction as observed in this study is post-operative adhesions arising from previous appendectomy and laparotomies.

摘要

背景

急性小肠梗阻是撒哈拉以南地区常见的外科急症。几十年来,复杂的腹股沟疝已被确定为主要原因。然而,我们从临床实践中观察到,复杂的腹股沟疝并不是最常见的病因。

目的和目标

本研究旨在评估研究中心急性小肠梗阻的常见病因,并将我们的发现与其他中心和现有文献进行比较。

材料和方法

这是一项回顾性、横断面研究,历时五年(2017 年 1 月至 2021 年 12 月)。本研究观察了在我院就诊的急性、机械性、小肠梗阻患者,这些患者经保守治疗无效。从患者的临床资料中提取相关信息并输入为此研究准备的表格中。

结果

本研究共纳入 147 例患者,其中 85 例(57.8%)为男性,62 例(42.2%)为女性(M:F=1.44:1)。大多数(80.3%)出现术后肠粘连的患者曾行阑尾切除术。93 例(63.3%)患者表现为单纯性肠梗阻,26 例(17.7%)患者和 22 例(15.0%)患者分别表现为绞窄性肠梗阻和坏疽性肠。大多数(47.6%)患者行粘连松解术,其他患者行肠切除术。

结论

本研究观察到急性小肠梗阻的常见病因是既往阑尾切除术和剖腹术引起的术后粘连。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39c8/11364338/1575309c2fa6/AAM-23-313-g001.jpg

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