title: Etiology and outcome of acute intestinal obstruction: a review of 367 patients in Eastern India.
abstract: OBJECTIVE
  The etiology of acute intestinal obstruction, which is one of the commonest surgical emergencies, varies between countries and has also changed over the decades. We aimed to provide a complete epidemiological description of acute intestinal obstruction in a tertiary care hospital in Eastern India.
  
  
  METHODS
  This was a retrospective study of patients admitted in our unit with a diagnosis of acute intestinal obstruction between the years 2005 and 2008 at Medical College, Calcutta. The study comprised of 367 patients.
  
  
  RESULTS
  Acute intestinal obstruction was the diagnosis in 9.87% of all patients admitted with males (75.20%) grossly outnumbering females. The commonest age group affected was 20-60 years. In our patients, the main cause of obstruction was obstructed hernia followed by malignancy with adhesions coming third. Intestinal tuberculosis was an important cause for obstruction in our patients comprising 14.17% of patients. Conservative management was advocated in 79 patients while the rest underwent surgery. Postoperative complications occurred in 95 patients and of these, 38 patients had a single complication and the rest, more than 1. The main complications were wound infection, basal atelectasis, burst abdomen and prolonged ileus. The mortality rate was 7.35% (27 patients). The highest mortality occurred in those with intestinal tuberculosis.
  
  
  CONCLUSIONS
  This study demonstrates that the pattern of intestinal obstruction differs from the Western world with obstructed hernias being the most important cause and also emphasizes the fact that intestinal tuberculosis assumes a prominent role. It also highlights the necessity of using universal precautions because of the ever increasing number of HIV patients in those with intestinal obstruction.
authors.affiliation: Department of Surgery, Medical College, Calcutta, India. souvikadhikari@rediffmail.com
authors.forename: Souvik
authors.initials: S
authors.lastname: Adhikari
authors.forename: Mohammed Zahid
authors.initials: MZ
authors.lastname: Hossein
authors.forename: Amitabha
authors.initials: A
authors.lastname: Das
authors.forename: Nilanjan
authors.initials: N
authors.lastname: Mitra
authors.forename: Udipta
authors.initials: U
authors.lastname: Ray
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D046449:Hernia, Abdominal / Q000150:complications; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016896:Treatment Outcome; D055815:Young Adult