Emergency Presentation and Surgical Management of Small Bowel Obstruction at a Tertiary Care Centre: A Hospital-Based Cross-Sectional Descriptive Study.

Dr R.  Tejashwini; Dr Dharavath  Gouthami; Supraja  Jonnalagadda; Dr .Sabavat Laxmi  Kalyani

doi:10.51168/sjhrafrica.v7i3.2552

Authors

Dr. R. Tejashwini Assistant Professor, Department of General Surgery, Government Medical College, Suryapet, Telangana, India.
Dr .Dharavath Gouthami Assistant Professor, Department of General Surgery, Government Medical College, Suryapet, Telangana, India.
Dr. Supraja Jonnalagadda Assistant Professor, Department of General Surgery, Government Medical College, Suryapet, Telangana, India.
Dr .Sabavat Laxmi Kalyani Assistant Professor, Department of General Surgery, Government Medical College, Suryapet, Telangana, India.

DOI:

https://doi.org/10.51168/sjhrafrica.v7i3.2552

Keywords:

small bowel obstruction, adhesions, hernia, laparotomy, adhesiolysis, surgical outcomes

Abstract

Background.

Small bowel obstruction is a frequent surgical emergency that demands rapid diagnosis, prompt resuscitation, and timely operative decision-making. Delayed treatment increases the risk of bowel ischemia, perforation, sepsis, and death.

Objectives.

To evaluate the clinical presentation, etiological profile, surgical management, and early postoperative outcomes of adult patients presenting with small bowel obstruction at a tertiary care centre.

Methods.

This hospital-based cross-sectional descriptive study with prospective data collection included 50 adult patients with mechanical small bowel obstruction admitted to the Department of General Surgery, Osmania General Hospital, Hyderabad, from January 2018 to December 2021. Diagnosis was based on history, physical examination, and standard clinical evaluation. All included patients underwent operative management after resuscitation, nasogastric decompression, antibiotic prophylaxis, and correction of fluid and electrolyte imbalance.

Results.

Patients aged 41–50 years constituted the largest group [26.0%], and men predominated [70.0%]. Abdominal pain was universal [100.0%], followed by vomiting [80.0%], constipation [56.0%], and abdominal distension [24.0%]. Most patients presented within 2–5 days of symptom onset [72.0%]. Adhesions, bands, and strictures were the leading causes [60.0%], followed by hernia [30.0%]. The most common operation was laparotomy with adhesiolysis [30.0%], followed by laparotomy with stoma formation [28.0%] and resection with anastomosis [20.0%]. Postoperative complications occurred in 10.0% of patients, including wound infection [4.0%], recurrent adhesions [4.0%], and death [2.0%].

Conclusion.

Adhesive disease was the dominant etiology of small bowel obstruction, and timely surgical intervention after adequate resuscitation resulted in favorable early outcomes in most patients.

Recommendations.

Early recognition of the classical symptom complex, prompt imaging, aggressive preoperative optimization, and decisive surgery in patients with complete obstruction or signs of severity should remain central to care. Strategies that reduce postoperative adhesion formation deserve emphasis.

Author Biographies

Dr. R. Tejashwini, Assistant Professor, Department of General Surgery, Government Medical College, Suryapet, Telangana, India.

is currently serving as an Assistant Professor at Government Medical College, Suryapet, Telangana, India. She completed her MBBS from Kakatiya Medical College, Warangal, Telangana, India, and subsequently obtained her MS in General Surgery from Osmania Medical College, Hyderabad, Telangana, India. She also completed one year of Senior Residency at Rajiv Gandhi Institute of Medical Sciences, Adilabad. Dr. Tejashwini has three years of teaching experience and is actively engaged in medical education, surgical training, and academic activities. ORCID ID: https://orcid.org/0009-0003-7311-1203
Dr .Dharavath Gouthami, Assistant Professor, Department of General Surgery, Government Medical College, Suryapet, Telangana, India.

is currently serving as an Assistant Professor at Government Medical College, Suryapet, Telangana, India. She completed her MBBS from Kakatiya Medical College, Warangal, and subsequently obtained her MS in General Surgery from the Upgraded Department of General Surgery, Osmania Medical College, Hyderabad. She also completed one year of Senior Residency at Osmania Medical College, Hyderabad. In addition, she holds FISCP [Fellowship of the International Society of Coloproctology].

Dr. Gouthami has extensive clinical and academic experience. She worked for four years as a Specialist Surgeon at Singareni Collieries Company Limited, Bhupalpally, Warangal, where she gained substantial surgical expertise in patient care and management. She also has three years of teaching experience and is actively involved in undergraduate medical education, surgical training, and academic activities. ORCID ID: https://orcid.org/0009-0009-4418-5522.
Dr. Supraja Jonnalagadda, Assistant Professor, Department of General Surgery, Government Medical College, Suryapet, Telangana, India.

is currently serving as an Assistant Professor at Government Medical College, Suryapet, Telangana, India. She completed her MBBS from Kasturba Medical College, Mangalore, and obtained her MS in General Surgery from Kamineni Institute of Medical Sciences, Narketpally. She subsequently completed her Senior Residency at Government Medical College, Suryapet. Dr. Jonnalagadda has three years of teaching experience and is actively involved in undergraduate medical education, surgical training, and academic activities. ORCID ID: https://orcid.org/0009-0003-6328-4135
Dr .Sabavat Laxmi Kalyani, Assistant Professor, Department of General Surgery, Government Medical College, Suryapet, Telangana, India.

is currently serving as an Assistant Professor at Government Medical College, Suryapet, Telangana, India. She completed her MBBS from Mediciti Institute of Medical Sciences and subsequently obtained her MS in General Surgery from Osmania Medical College, Hyderabad, Telangana, India. She further completed one year of Senior Residency at Government Medical College, Mancherial, Telangana, India. In addition, she holds FISCP [Fellowship of the International Society of Coloproctology]. Dr. Kalyani has three years of teaching experience and is actively involved in surgical education, clinical training, and academic activities. ORCID Id: https://orcid.org/0009-0002-5061-023X

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