1887
Volume 2025, Issue 2
  • ISSN: 1999-7086
  • E-ISSN: 1999-7094

This study aims to investigate the clinical presentation, etiology, and management outcomes of acute mechanical bowel obstruction (AMBO) in Yemen, focusing on predictors of postoperative complications and mortality.

A prospective observational study was conducted at Al-Thawra Modern General Hospital in Sana’a, Yemen, from October 2022 to October 2023. We enrolled 106 patients with AMBO, collecting data on demographics, clinical presentation, management strategies, surgical interventions, complications, and outcomes. Logistic regression identified risk factors for postoperative complications and mortality.

The study population consisted predominantly of males (66%) aged 31–60 (51%). Common symptoms included vomiting (96.2%), constipation (90.6%), and abdominal distention (83.0%). Adhesions (41.5%) were the most frequent cause, followed by hernias and large bowel masses (22.6% each). Surgical intervention was necessary in 71.7% of cases, with resection and anastomosis as the most common procedure (29.2%). Postoperative complications occurred in 36.8% of surgical patients, with wound infections being the most prevalent (31.6%). Significant predictors of complications included resection and anastomosis (OR = 19.541, 95% CI: 3.655–104.466, = 0.001) and delayed presentation (7–10 days) (OR = 11.433, 95% CI: 1.230–106.252, = 0.032). Mortality was associated with ICU admission (OR = 1.719, 95% CI: 1.019–2.904, = 0.029), sepsis (OR = 2.771, 95% CI: 1.451–5.292, < 0.001), and hypothermia (OR = 1.451, 95% CI: 1.019–2.071, = 0.042).

AMBO predominantly affects middle-aged males in Yemen, with adhesions being the leading cause. Surgical intervention, while often necessary, carries significant risks, particularly with delayed presentation. Early diagnosis and timely intervention are crucial to improving patient outcomes. Further studies are needed to validate these findings and develop optimized treatment protocols.

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References

  1. Mucha P. Small intestinal obstruction. Surg Clin North Amer. 1987; 67:(3):597–620. https://doi.org/10.1016/S0039-6109(16)44234-9
    [Google الباحث العلمي]
  2. Miller G, Boman J, Shrier I, Gordon PH. Natural history of patients with adhesive small bowel obstruction. Br J Surg. 2002; 87:(9):1240–1247. https://doi.org/10.1046/j.1365-2168.2000.01530.x
    [Google الباحث العلمي]
  3. Miller G, Boman J, Shrier I, Gordon PH. Etiology of small bowel obstruction. Ameri J Surg. 2000; 180:(1):33–36. https://doi.org/10.1016/S0002-9610(00)00407-4
    [Google الباحث العلمي]
  4. Ihedioha U, Alani A, Modak P, Chong P, O’Dwyer PJ. Hernias are the most common cause of strangulation in patients presenting with small bowel obstruction. Hernia. 2006; 10:(4):338–340. https://doi.org/10.1007/s10029-006-0101-7
    [Google الباحث العلمي]
  5. Kwarshak YK, Yisa MN, Kigbu OA, et al. Systematic review protocol of aetiology of mechanical bowel obstruction in low-and-middle income countries: Has anything changed in the last two decades? PLoS One. 2024; 19:(5):e0295477. https://doi.org/10.1371/journal.pone.0295477
    [Google الباحث العلمي]
  6. Lawal OO, Olayinka OS, Bankole JO. Spectrum of causes of intestinal obstruction in adult Nigerian patients. S Afr J Surg. 2005; 43:(2):34, 36.
    [Google الباحث العلمي]
  7. Mthethwa MR, Aldous C, Madiba TE. Clinicopathological spectrum of small bowel obstruction and management outcomes in adults – experience at a regional academic hospital complex. S Afr J Surg. 2021; 59:(3):118–123.
    [Google الباحث العلمي]
  8. Markogiannakis H. Acute mechanical bowel obstruction: Clinical presentation, etiology, management and outcome. World J Gastroenterol. 2007; 13:(3):432. https://doi.org/10.3748/wjg.v13.i3.432
    [Google الباحث العلمي]
  9. Bayleyegn NS. Evaluation of clinical profiles, surgical experience and outcomes of ileosigmoid knotting in low-resource setup: A retrospective cohort study at Jimma University Medical Center. World J Surg. 2024; 48:(6):1331–1347. https://doi.org/10.1002/wjs.12155
    [Google الباحث العلمي]
  10. Ooko PB, Sirera B, Saruni SI, Topazian HM, White RE. Pattern of adult intestinal obstruction at Tenwek hospital, in South-Western Kenya. Pan Afr Med J. 2015;20. https://doi.org/10.11604/pamj.2015.20.31.5830
    [Google الباحث العلمي]
  11. Fekadu G, Tolera A, Bayissa BB, Merga BT, Edessa D, Lamessa A. Epidemiology and causes of intestinal obstruction in Ethiopia: A systematic review. SAGE Open Med. 2022; 10:205031212210832. https://doi.org/10.1177/20503121221083207
    [Google الباحث العلمي]
  12. Kössi J, Salminen P, Laato M. The Epidemiology and treatment patterns of postoperative adhesion induced intestinal obstruction in Varsinais-Suomi Hospital District. Scand J Surg. 2004; 93:(1):68–72. https://doi.org/10.1177/145749690409300115
    [Google الباحث العلمي]
  13. Williams SB, Greenspon J, Young HA, Orkin BA. Small bowel obstruction: conservative vs. surgical management. Dis Colon Rectum. 2005; 48:(6):1140–1146. https://doi.org/10.1007/s10350-004-0882-7
    [Google الباحث العلمي]
  14. Karakas DÖ, Yesiltas M, Gökçek B, Egin S, Hot S. Etiology, management, and survival of acute mechanical bowel obstruction: Five-year results of a training and research hospital in Turkey. Ulus Travma Acil Cerrahi Derg. 2019; 25:(3):268–280. https://doi.org/10.14744/tjtes.2019.44834
    [Google الباحث العلمي]
  15. Cheadle WG, Garr EE, Richardson JD. The importance of early diagnosis of small bowel obstruction. Am Surg. 1988; 54:(9):565–569.
    [Google الباحث العلمي]
  16. Sarr MG, Bulkley GB, Zuidema GD. Preoperative recognition of intestinal strangulation obstruction. Amer J Surg. 1983; 145:(1):176–182. https://doi.org/10.1016/0002-9610(83)90186-1
    [Google الباحث العلمي]
  17. Kuremu R, Jumbi G. Adhesive intestinal obstruction. East Afr Med J. 2006; 83:(6). https://doi.org/10.4314/eamj.v83i6.9441
    [Google الباحث العلمي]
  18. Sheth D, Patel A, Mishra G. A randomized study of conservative vs operative management of intestinal obstruction. Int J Sci Res. 2023; 12:(6):2277–8179. https://doi.org/10.36106/ijsr%2F3719284
    [Google الباحث العلمي]
  19. Oyinlola M, Omisakin O. A study of intestinal obstruction conservative versus surgical management. Int Med Sci Res J. 2020; 1:(2):10–16. https://doi.org/10.51594/imsrj.v1i2.59
    [Google الباحث العلمي]
  20. Meier RPH, de Saussure WO, Orci LA, et al. Clinical outcome in acute small bowel obstruction after surgical or conservative management. World J Surg. 2014; 38:(12):3082–3088. https://doi.org/10.1007/s00268-014-2733-6
    [Google الباحث العلمي]
  21. Maung AA, Johnson DC, Piper GL, et al. Evaluation and management of small-bowel obstruction. J Trauma Acute Care Surg. 2012; 73:(5):S362–S369. https://doi.org/10.1097/TA.0b013e31827019de
    [Google الباحث العلمي]
  22. Bugalia RP, Meena H, Kumar S. A descriptive study of clinical presentation, etiology and management in acute mechanical bowel obstruction. Int J Res Rev. 2021; 8:(9):136–141. https://doi.org/10.52403/ijrr.20210919
    [Google الباحث العلمي]
  23. Islam MdZ, Islam MdA, Alom MdA, E-Khuda IMdK, Ullah MdS, Momotaz MstT. Management and outcome of acute mechanical bowel obstruction in a teaching hospital. Schol J Appl Med Sci. 2022; 10:(11):2026–2035. https://doi.org/10.36347/sjams.2022.v10i11.038
    [Google الباحث العلمي]
  24. Khan T, Wani M, Wani S, et al. Clinico-pathological profile and management of acute mechanical small bowel obstruction: A prospective study. Arch Clin Exp Surg. 2013; 2:(3):154. https://doi.org/10.5455/aces.20120512025139
    [Google الباحث العلمي]
  25. Simachew A, Haile D, Tesfaye B, et al. Mortality and its associated factors of bowel obstruction after surgical treatment among adult patients at Debre Markos comprehensive specialized hospital, Northwest Ethiopia 2021 (retrospective cross-sectional study). https://doi.org/10.21203/rs.3.rs-952644/v1
    [Google الباحث العلمي]
  26. Xu N, Sun BJ, Yue TM, Lee B. Factors predicting readmission and mortality in patients admitted for malignant bowel obstruction. Am Surg. 2024; 90:(10):2570–2576. https://doi.org/10.1177/00031348241250045
    [Google الباحث العلمي]
  27. Sumbal R, Ali Baig MM, Sumbal A. Predictors of mortality in acute mesenteric ischemia: A systematic review and meta-analysis. J Surg Res. 2022; 275:72–86. https://doi.org/10.1016/j.jss.2022.01.022
    [Google الباحث العلمي]
  28. Awedew A, Amsalu T, Belay W, et al. Magnitude and management outcome predictors of mechanical large bowel obstruction. Ethiop Med J. 2021; 59:111–116. Available from: https://emjema.org/index.php/EMJ/article/view/1565
    [Google الباحث العلمي]
  29. Dikicier E, Akdeniz Y, Özdemir K, Kamburoglu M, Mantoglu B, Gönüllü E. A common surgical emergency in elderly: acute mechanical bowel obstruction. J Biotechnol Strat Health Res. 2020; 4:(2):156–165. https://doi.org/10.34084/bshr.777004
    [Google الباحث العلمي]
  30. Sharma R, Chandel UK, Kaundal A. Socio-demographic and clinical characteristics of patients with acute intestinal obstruction at tertiary care Institute of North India. Int Acad Res J Surg. 2022; 2:(4):1–4. https://doi.org/10.47310/iarjs.2022.v02i04.001
    [Google الباحث العلمي]
  31. Bender JS, Busuito MJ, Graham C, Allaben RD. Small bowel obstruction in the elderly. Am Surg. 1989; 55:(6):385–388.
    [Google الباحث العلمي]
  32. Shotton H, Kelly K, Sinclair M, Michalski A. Delay in transit: the NCEPOD review of care provided to patients with acute bowel obstruction. Br J Hosp Med. 2021; 82:(1):1–1. https://doi.org/10.12968/hmed.2020.0399
    [Google الباحث العلمي]
  33. Chitumalla PK, Vemulapally NK, Reddy S. Clinical study of bowel obstruction in relation to etiological factors. Int Surg J. 2017; 4:(2):1–1. https://doi.org/10.18203/2349-2902.isj20164846
    [Google الباحث العلمي]
  34. Teixeira PG, Karamanos E, Talving P, Inaba K, Lam L, Demetriades D. Early operation is associated with a survival benefit for patients with adhesive bowel obstruction. Ann Surg. 2013; 258:(3):459–465. https://doi.org/10.1097/SLA.0b013e3182a1b100
    [Google الباحث العلمي]
  35. Babu DSR. Current trend in acute intestinal obstruction incidence – A combined retrospective and prospective study. J Med Sci Clin Res. 2020; 08:(11). https://doi.org/10.18535/jmscr/v8i11.03
    [Google الباحث العلمي]
  36. Karuppasamy P. Clinical study of surgical management of acute intestinal obstruction in the adults at a tertiary hospital. MedPulse Int J Surg. 2021; 20:(3):98–102. https://doi.org/10.26611/10620310
    [Google الباحث العلمي]
  37. Falola AF, Dada OS, Ndong A, Akande DG. Etiology and management outcomes of adult mechanical bowel obstruction in Nigeria: A systematic review and meta-analysis. World J Surg. 2024; 48:(1):29–39. https://doi.org/10.1002/wjs.12017
    [Google الباحث العلمي]
  38. Paul D, Saqeb KMN, Sarker SA. Risk factors for post-operative complications of surgical interventions done in small bowel obstruction (SBO): A study of 100 cases. Bangl Crit Care J. 2021; 9:(2):87–93. https://doi.org/10.3329/bccj.v9i2.56155
    [Google الباحث العلمي]
  39. Fevang BT, Jensen D, Svanes K, Viste A. Early operation or conservative management of patients with small bowel obstruction?. Eur J Surg. 2002; 168:(8):475–481. https://doi.org/10.1080/110241502321116488
    [Google الباحث العلمي]
  40. Tang E. Bowel obstruction in cancer patients. Arch Surg. 1995; 130:(8):832. https://doi.org/10.1001/archsurg.1995.01430080034004
    [Google الباحث العلمي]
  41. Clarke A. Length of stay: How short should hospital care be? Eur J Public Health. 2001; 11:(2):166–170. https://doi.org/10.1093/eurpub/11.2.166
    [Google الباحث العلمي]
  42. Abela L, Pace A, Buttigieg SC. What affects length of hospital stay? A case study from Malta. J Health Organ Manag. 2019; 33:(6):714–736. https://doi.org/10.1108/JHOM-10-2018-0280
    [Google الباحث العلمي]
  43. Bankole A, Osinowo A, Adesanya A. Predictive factors of management outcome in adult patients with mechanical intestinal obstruction. Niger Postgr Med J. 2017; 24:(4):217. https://doi.org/10.4103/npmj.npmj_143_17
    [Google الباحث العلمي]
  44. Khodorkovsky B, Youssef E, Adamakos F, et al. Does initial temperature in the emergency department predict outcomes in patients admitted for sepsis? J Emerg Med. 2018; 55:(3):372–377. https://doi.org/10.1016/j.jemermed.2018.06.008
    [Google الباحث العلمي]
  45. Pittet D, Thiévent B, Wenzel RP, Li N, Auckenthaler R, Suter PM. Bedside prediction of mortality from bacteremic sepsis. A dynamic analysis of ICU patients. Am J Respir Crit Care Med. 1996; 153:(2):684–693. https://doi.org/10.1164/ajrccm.153.2.8564118
    [Google الباحث العلمي]
  46. Albabtain IT, Almohanna RS, Alkhuraiji AA, et al. Risk factors for the systemic inflammatory response syndrome and sepsis following surgical management of acute intestinal obstruction. Int J Health Sci (Qassim). 2021; 15:(6):28–33.
    [Google الباحث العلمي]
  47. Glaser J, Farrell MS, Caplan R, Rubino M. Operative rates in acute diverticulitis with concurrent small bowel obstruction. Trauma Surg Acute Care Open. 2022; 7:(1):e000925. https://doi.org/10.1136/tsaco-2022-000925
    [Google الباحث العلمي]
  48. Deolekar SR, Mahapatra B, Subudhi S, Singhal P. A study of surgical management and its outcome in adult patients with intestinal obstruction. Int Surg J. 2019; 6:(12):4370. https://doi.org/10.18203/2349-2902.isj20195396
    [Google الباحث العلمي]
  49. Chakravarthy DDS. Clinical study of acute intestinal obstruction. J Med Sci Clin Res. 2019; 7:(2). https://doi.org/10.18535/jmscr/v7i2.190
    [Google الباحث العلمي]
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  • نوع المستند: Research Article
الموضوعات الرئيسية Acute mechanical bowel obstructionclinical presentationetiologymortalitypostoperative complications and surgical management

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