Changing Pattern of Mechanical Bowel Obstruction and Management Outcome in North-Eastern Nigeria

Background The study reviewed mechanical bowel obstruction over a five year period in North-EasternNigeria. Patients and Methods. The study retrospectively reviewed all patients that presented withmechanical bowel obstruction between January 2011 and December 2015. Permission for the study wasgranted by the Hospital management and informed consent obtained from all patients. Informationextracted from clinical and laboratory records and data analyzed using SPSS statistical analysis. Allpatients were resuscitated using intravenous fluids, antibiotics (ceftriaxone/ metronidazole), tetanustoxoid, blood, and diverting colostomy where necessary. All patients had bowel preparation beforedefinitive surgery under general anesthesia. Results. A total of 94 patients were managed age rangedbetween 20 and 72 years with male to female ratio of 1.4:1. The peak age group was 21- 30yearsaccounting for 29.78%, followed by age group 51-60 years in 27.66% table 1. Tumour was thecommonest cause in 27.66% followed by external hernias and intra peritoneal adhesions that failed toresolve on conservative management in the same proportion of 25.53% each table 2. The procedurescarried were bowel resection in 54.26% and herniorrhapy in 25.53% table 3. The post operativecomplications were surgical site infection in 22.34%, enterocutaneos fistula in 3.19%. The mortalityrecorded was 15.96% majority due to metastatic colonic tumour. Conclusion. The rising incidence ofcolonic tumours and late presentation in the developing world and falling complicated external herniasdue to availability of elective operations makes the former to become the most frequent cause ofmechanical bowel obstruction in this environment.