Clinical profile and outcome of acute intestinal obstruction among adults: An observational study
Asif Ali, Murtaza Ayoub, Abrar Hussain Teli, Adnan Hamid, Ajaz Ahmad Malik, Munir Ahmad WaniObjectives:
Mechanical or functional blockage of intestinal transit acute intestinal obstruction (AIO) continues to represent a frequent indication for emergency surgical consultation, carrying appreciable morbidity and case fatality. The causal profile and prognosis differ markedly across populations and healthcare settings. We sought to delineate the clinical phenotype, causative factors, therapeutic approaches, and mortality determinants among adults presenting with AIO at a North Indian tertiary facility.
Material and Methods:
Over a 24-month period, we prospectively observed 280 consecutive adult patients (≥18 years) exhibiting features of AIO at the Department of General and Minimally Invasive Surgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar. Enrollment relied on convenience sampling. Comprehensive data spanning demographics, symptomatology, physical findings, biochemical markers, and cross-sectional imaging were compiled. Management followed institutional algorithms either non-operative or operative with endpoints encompassing postoperative morbidity, length of inpatient stay, and all-cause mortality. Categorical associations were examined via Chi-square or Fisher’s exact test; independent mortality predictors were isolated through multivariable logistic regression.
Results:
Participants averaged 49.9 ± 14.6 years of age; the modal bracket was 46–60 years (37.1%). Men comprised 61.4%, and rural residents accounted for 65.0%. Concurrent medical illness was documented in 42.1%. Every patient reported abdominal pain; accompanying features included distension (86.0%), emesis (81.0%), and absent bowel movements (76.7%). Over half (52.9%) reached the facility between 24 hours and 3 days from onset. Adhesive disease topped the etiologic list (56.1%), trailed by neoplasia (26.1%) and incarcerated hernia (8.2%). Conservative measures resolved roughly two-thirds of adhesive cases, whereas neoplastic, hernial, volvular, stricturing, and intussusception cases uniformly required operative correction. Among those undergoing surgery, 33.3% experienced complications surgical site infection prevailing (14.3%). Mean hospitalisation lasted 8.4 ± 3.2 days. Thirteen individuals (4.7%) died. Logistic regression isolated four independent risk factors for death: age exceeding 60 years (aOR 6.5, 95% CI 1.2–34.8; p = 0.028), co-existing illness (aOR 5.8, 95% CI 1.3–24.5; p = 0.018), malignant cause (aOR 7.2, 95% CI 1.8–28.4; p = 0.005), and postoperative morbidity (aOR 9.5, 95% CI 2.2–40.1; p = 0.002).
Conclusion:
In this cohort, AIO primarily burdened middle-aged and older men, with adhesive and malignant aetiologies predominating. Although aggregate survival was encouraging, advanced age, comorbidity burden, cancer-related obstruction, and postoperative complications amplified mortality risk substantially. Prompt recognition, risk-tiered triage, and timely therapeutic intervention remain pivotal to improving survival.