Dhruvesh Sheth, Aashay Patel, Gaurav Mishra

A RANDOMIZED STUDY OF CONSERVATIVE VS OPERATIVE MANAGEMENT OF INTESTINAL OBSTRUCTION

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The aim of this study was to assess incidence, risk factors, and recurrence rates forconservative and surgical management of intestinal obstruction. Methods: Retrospective chart review was conducted of 100 patients which were randomised select admissions with bowel obstruction. The materials for the clinical study of intestinal obstruction were collected from cases admitted in Narendra Modi Medical College (L. G. Hospital, Maningar, Ahmedabad) during the period from May 2022 to April 2023. Patients are belonged to any age groups. Patients who were having intestinal obstruction treated either conservatively or surgically were studied to establish the pathology of intestinal obstruction with an aim to know the mode of presentation, physical ndings, radiological ndings, operative ndings and outcome of intestinal obstruction. Results: 24 percent were successfully treated conservatively, whereas 76 percent failed conservative treatment and underwent surgery. Most commonly used procedure in operative management was resection and anastamosis (27.60%). Adhesiolysis was also done in 23.70%. Duration stay in hospital was higher in operative cases (13.4 days) compare to conservative cases (5.13 days) but recurrence rate was more common in conservative approach (16.66%) compare to operative method (2.63%). Conclusion: Success in the treatment of intestinal obstruction depends largely upon early diagnosis, skilful management and treating the pathological effects of the obstruction just as much as the cause itself. Patient with intestinal obstruction should be admitted in emergency ward and thoroughly examined. After early resuscitation, investigation should be planned. Mostly erect abdominal x-ray is planned for diagnosis and location of intestinal obstruction. Proper resuscitation before surgery is key factor for recovery of patient. Patients who showed reduction in abdominal distension, improving peristalsis, reduction in pain/tenderness and improvement in general condition treated by conservative management otherwise operate the patient if there was no improvement. Closed observation is need in conservative method. Operatively treated patients had a lower frequency of recurrence; however, they also had a longer hospital stay than that of patients treated nonoperatively.

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