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Biswas e al. In e na ional Jou nal o Cu en Pha maceu ical Re iew and Resea ch
464
O iginal Resea ch A icle
A S udy o Clinico-Epidemiological P o ile, Managemen and Ou come o
Acu e In es inal Obs uc ion in a Te ia y Ca e Hospi al
Rahul Biswas1, Mano anjan Ka 2, Sau abh Das3
1Tu o , MBBS, MS, DNB, Depa men o Gene al Su ge y, IPGME & R, SSKM Hospi al, Wes Bengal,
Kolka a-700020
2P o esso , MBBS, MS, Depa men o Gene al Su ge y, Midnapo e Medical College and Hospi al,
Midnapo e, Wes Bengal, India –721101
3Associa e P o esso , MBBS, MS, Depa men o Gene al Su ge y, IPGME & R, SSKM Hospi al, ,Wes
Bengal, Kolka a-700020
Recei ed: 01-07-2025 / Re ised: 16-08-2025 / Accep ed: 02-09-2025
Co esponding Au ho : D . Rahul Biswas
Con lic o in e es : Nil
Abs ac
In oduc ion: Acu e in es inal obs uc ion (AIO) is a common su gical eme gency cha ac e ized by he pa ial o
comple e blockage o he in es ines, leading o impai ed passage o in es inal con en s and signi ican mo bidi y
i no p omp ly managed.
Aims: Acu e in es inal obs uc ion is a common su gical eme gency equi ing p omp diagnosis, pe iope a i e
managemen , and su gical skill o achie e a o able ou comes. This s udy aimed o e alua e he causes, clinic-
epidemiological ea u es, and se e i y indica o s o in es inal obs uc ion, as well as o assess pa ien ou comes
ollowing conse a i e and su gical managemen .
Ma e ials & Me hods: This was a p ospec i e clinical s udy conduc ed a Midnapo e Medical College and
Hospi al, Midnapo e, om 1s Ap il 2021 o 1s Oc obe 2022. The s udy included a o al o 100 pa ien s
diagnosed wi h acu e in es inal obs uc ion.
Resul : The mos equen diagnosis was obs uc ed he nia in 35 pa ien s (35%), ollowed by adhesions in 18
pa ien s (18%), sigmoid ol ulus in 12 pa ien s (12%), g ow hs in 14 pa ien s (14%), ileal s ic u es/TB in 8
pa ien s (8%), in ussuscep ion in 6 pa ien s (6%), small gu gang ene in 3 pa ien s (3%), and o he causes in 4
pa ien s (4%) (p < 0.00001). In ou s udy, pos ope a i e complica ions we e obse ed in a mino i y o pa ien s,
wi h 64 pa ien s (64%) expe iencing no complica ions. Wound in ec ion occu ed in 20 pa ien s (20%), wound
gaping in 10 pa ien s (10%), and dea h was epo ed in 6 pa ien s (6%)i was highly s a is ically signi ican (p <
0.0001).
Conclusion: We conclude ha , he mos common diagnosis was obs uc ed he nia, ollowed by adhesions,
sigmoid ol ulus, neoplas ic g ow hs, ileal s ic u es/TB, in ussuscep ion, small gu gang ene, and o he less
equen causes. Pos ope a i e complica ions we e ela i ely uncommon, wi h he majo i y o pa ien s
expe iencing an une en ul eco e y. The mos equen ly obse ed complica ions included wound in ec ion,
wound dehiscence, and mo ali y. O e all, he ou comes sugges ha while su gical in e en ion ca ies inhe en
isks, mos pa ien s eco e wi hou signi ican pos ope a i e complica ions.
Keywo ds: Acu e in es inal obs uc ion, He nia, Adhesions, Bowel obs uc ion and Wound in ec ion.
This is an Open Access a icle ha uses a unding model which does no cha ge eade s o hei ins i u ions o access and dis ibu ed unde
he e ms o he C ea i e Commons A ibu ion License (h p://c ea i ecommons.o g/licenses/by/4.0) and he Budapes Open Access Ini ia i e
(h p://www.budapes openaccessini ia i e.o g/ ead), which pe mi un es ic ed use, dis ibu ion, and ep oduc ion in any medium, p o ided
o iginal wo k is p ope ly c edi ed.
In oduc ion
Acu e in es inal obs uc ion (AIO) is a common
su gical eme gency cha ac e ized by he pa ial o
comple e blockage o he in es ines, leading o
impai ed passage o in es inal con en s and
signi ican mo bidi y i no p omp ly managed. I
a ec s pa ien s ac oss all age g oups, wi h a highe
incidence in males and peak occu ence be ween 20
and 60 yea s [1]. The e iology is mul i ac o ial, wi h
obs uc ed he nias, pos ope a i e adhesions,
ol ulus, umo s, and s ic u es being he mos
equen causes [2,3]. Clinically, pa ien s p esen
wi h abdominal pain, omi ing, dis ension, and
obs ipa ion, while examina ion may e eal high-
pi ched bowel sounds, ende ness, and isible
pe is alsis [3]. Managemen in ol es ea ly
esusci a ion, conse a i e measu es, and imely
su gical in e en ion based on he unde lying cause,
wi h ou comes dependen on p omp diagnosis and
pe iope a i e ca e [4]. Unde s anding he clinic-
epidemiological p o ile, managemen s a egies, and
ou comes o AIO is essen ial o op imizing pa ien
ca e and educing associa ed mo bidi y and
mo ali y. Whe he b ough on by he nia, umou ,
adhesions, o biochemical changes, in es inal
In e na ional Jou nal o Cu en Pha maceu ical Re iew and Resea ch e-ISSN: 0976-822X, p-ISSN: 2961-6042
Biswas e al. In e na ional Jou nal o Cu en Pha maceu ical Re iew and Resea ch
465
obs uc ion o ei he he small o la ge bowel
con inues o be a majo cause o mo bidi y and
mo ali y. I is one o he mos equen in a-
abdominal issues encoun e ed by gene al su geons
in hei p ac ise. They ep esen 12% o 16% o
admissions o su ge y o sudden abdominal pain.
Acu e in es inal obs uc ion symp oms migh ange
om a e y no mal appea ance wi h only li le
abdominal pain and dis ension o a condi ion o
hypo olemic o sep ic shock (o bo h) necessi a ing
an eme gency p ocedu e. The numbe o a ali ies
b ough on by acu e in es inal obs uc ion is
declining as pa hophysiology is be e unde s ood.
Imp o emen s in diagnos ic me hods, hyd a ion and
elec oly e managemen , e y e ec i e
an imic obials, and c i ical ca e skills.
The majo i y o a ali ies in ol e elde ly pa ien s
who seek he apy oo la e and ha e co-occu ing
condi ions including diabe es melli us, hea disease,
o pulmona y disease. Ea ly de ec ion o
obs uc ion, expe su gical managemen , co ec
echnique du ing su ge y, and ho ough
pos ope a i e ca e all yield posi i e esul s. S udy
aims acu e in es inal obs uc ion is a common
su gical eme gency equi ing p omp diagnosis,
pe iope a i e managemen , and su gical skill o
achie e a ou able ou comes. This s udy aimed o
e alua e he causes, clinic-epidemiological ea u es,
and se e i y indica o s o in es inal obs uc ion, as
well as o assess pa ien ou comes ollowing
conse a i e and su gical managemen .
Ma e ials and Me hods
Type o S udy: P ospec i e Clinical S udy
Place o S udy: Midnapo e Medical College and
Hospi al, Midnapo e
S udy Du a ion
1s Ap il 2021 o 1s Oc obe 2022
Sample Size: 100 Acu e In es inal Pa ien s
Inclusion c i e ia
• Pa ien s o all ages and bo h sexes p esen ing
wi h ea u es sugges i e o acu e in es inal
obs uc ion.
• Pa ien s diagnosed wi h in es inal obs uc ion
based on clinical e alua ion, adiological
imaging, o bo h.
• Pa ien s admi ed o he e ia y ca e hospi al o
su gical managemen o in es inal obs uc ion.
• Pa ien s who p o ided in o med consen o
pa icipa ion in he s udy.
• Pa ien s unde going ei he eme gency o
elec i e su ge y o con i med causes o
in es inal obs uc ion.
Exclusion c i e ia
• Pa ien s wi h ch onic o pa ial in es inal
obs uc ion wi hou acu e p esen a ion.
• Pa ien s managed en i ely on an ou pa ien basis
wi hou hospi al admission.
• Pa ien s wi h se e e como bidi ies and only
managed conse a i ely.
• Pa ien s who e used o gi e in o med consen
o pa icipa ion in he s udy.
• Pa ien s wi h incomple e clinical o adiological
eco ds p e en ing p ope e alua ion.
S udy a iables
• Age
• Sex
• P esen ing symp oms
• Clinical signs
• Causes o obs uc ion
S a is ical analysis
Da a we e en e ed in o excel and analyzed using
SPSS and g aphpad p ism. Nume ical a iables
we e summa ized using means and s anda d
de ia ions, while ca ego ical a iables we e
desc ibed wi h coun s and pe cen ages.
Two-sample - es s we e used o compa e
independen g oups, while pai ed - es s accoun ed
o co ela ions in pai ed da a. Chi-squa e es s
(including ishe ’s exac es o small sample sizes)
we e used o ca ego ical da a compa isons. P-
alues ≤ 0.05 we e conside ed s a is ically
signi ican .
Resul
Table 1: Dis ibu ion o Age g oup
Age G oup
Numbe o Pa ien s
Pe cen age (%)
p- alue
10–19
4
4%
.0005
20–29
13
13%
30–39
17
17%
40–49
15
15%
50–59
20
20%
60–69
17
17%
70–79
14
14%
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Biswas e al. In e na ional Jou nal o Cu en Pha maceu ical Re iew and Resea ch
466
Table 2: Dis ibu ion o Sex-wise dis ibu ion o Pa ien s
Sex
Numbe o Pa ien s
Pe cen age (%)
p- alue
Male
68
68%
< .0001
Female
32
32%
Table 3: Dis ibu ion o Clinical Symp oms, Signs, Disease Spec um
Numbe o Pa ien s
Pe cen age
(%)
p- alue
Clinical
Symp oms
Abdominal Pain
100
100%
< .00001
Vomi ing
81
81%
Dis ension
67
67%
Obs ipa ion
52
52%
Clinical
Signs
Bowel Sounds
79
79%
< .00001
Ballooning on DRE
53
53%
Visible Pe is alsis
10
10%
Diagnosis
Obs uc ed He nia
35
35%
< .00001.
Adhesion
18
18%
Sigmoid Vol ulus
12
12%
G ow h
14
14%
Ileal S ic u es / TB
8
8%
In ussuscep ion
6
6%
Small Gu Gang ene
3
3%
O he s
4
4%
Type o
He nia
Inguinal
29
82.80%
< .00001
Incisional
3
8.60%
Femo al
2
5.70%
Epigas ia
1
2.90%
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Biswas e al. In e na ional Jou nal o Cu en Pha maceu ical Re iew and Resea ch
467
Table 4: Dis ibu ion o Managemen
T ea men
Numbe o Cases
Pe cen age (%)
p- alue
Reduc ion and He nia Repai
30
30%
< .00001
Adhesiolysis
17
17%
Resec ion and Anas omosis
13
13%
Sigmoidec omy
11
11%
Righ Hemicolec omy
5
5%
Ha man P ocedu e
4
4%
Ileos omy
4
4%
Double Ba el Ileos omy
3
3%
O he s
13
13%
Table 5: Dis ibu ion o Complica ions
Complica ion
Numbe o Pa ien s
Pe cen age (%)
p- alue
No Complica ions
64
64%
< .0001
Wound In ec ion
20
20%
Wound Gaping
10
10%
Dea h
6
6%
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Biswas e al. In e na ional Jou nal o Cu en Pha maceu ical Re iew and Resea ch
468
Figu e 1: Dis ibu ion o Complica ions
Figu e 2: Dis ibu ion o : Clinical Symp oms and Signs
In ou s udy, he age dis ibu ion o pa ien s showed
ha he majo i y we e in he 50–59 yea s g oup, wi h
20 pa ien s (20%), ollowed by 17 pa ien s (17%)
each in he 30–39 and 60–69 yea s age g oups.
Fi een pa ien s (15%) we e aged 40–49 yea s, 14
pa ien s (14%) we e in he 70–79 yea s g oup, 13
pa ien s (13%) we e 20–29 yea s, and he leas
numbe o pa ien s, 4 (4%), we e in he 10–19 yea s
g oup. The age dis ibu ion was s a is ically
signi ican (p = 0.0005). In ou s udy, he majo i y
o pa ien s we e male, wi h 68 pa ien s (68%), while
emales accoun ed o 32 pa ien s (32%). This
di e ence in sex dis ibu ion was highly s a is ically
signi ican (p < 0.0001). In ou s udy, he mos
common clinical symp om was abdominal pain,
p esen in all 100 pa ien s (100%), ollowed by
omi ing in 81 pa ien s (81%), abdominal dis ension
in 67 pa ien s (67%), and obs ipa ion in 52 pa ien s
(52%) (p < 0.00001). Clinical signs included bowel
sounds in 79 pa ien s (79%), ballooning on digi al
ec al examina ion in 53 pa ien s (53%), and isible
pe is alsis in 10 pa ien s (10%) (p < 0.00001). The
mos equen diagnosis was obs uc ed he nia in 35
pa ien s (35%), ollowed by adhesions in 18 pa ien s
(18%), sigmoid ol ulus in 12 pa ien s (12%),
g ow hs in 14 pa ien s (14%), ileal s ic u es/TB in
8 pa ien s (8%), in ussuscep ion in 6 pa ien s (6%),
small gu gang ene in 3 pa ien s (3%), and o he
causes in 4 pa ien s (4%) (p < 0.00001). Among
ypes o he nia, inguinal he nia was p edominan in
29 pa ien s (82.8%), ollowed by incisional he nia in
3 pa ien s (8.6%), emo al he nia in 2 pa ien s
(5.7%), and epigas ia he nia in 1 pa ien (2.9%) i
was highly s a is ically signi ican (p < 0.0001). In
ou s udy, he mos common ea men was educ ion
and he nia epai , pe o med in 30 pa ien s (30%),
ollowed by adhesiolysis in 17 pa ien s (17%),
esec ion and anas omosis in 13 pa ien s (13%),
sigmoidec omy in 11 pa ien s (11%), igh
hemicolec omy in 5 pa ien s (5%), Ha man
p ocedu e in 4 pa ien s (4%), ileos omy in 4 pa ien s
(4%), double ba el ileos omy in 3 pa ien s (3%), and
o he p ocedu es in 13 pa ien s (13%) i was highly
s a is ically signi ican (p < 0.0001). In ou s udy,
pos ope a i e complica ions we e obse ed in a
mino i y o pa ien s, wi h 64 pa ien s (64%)
expe iencing no complica ions. Wound in ec ion
occu ed in 20 pa ien s (20%), wound gaping in 10
pa ien s (10%), and dea h was epo ed in 6 pa ien s
(6%)i was highly s a is ically signi ican (p <
0.0001).
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Biswas e al. In e na ional Jou nal o Cu en Pha maceu ical Re iew and Resea ch
469
Discussion
We ound ha in ou s udy, he mos common age
g oup among pa ien s was 50–59 yea s, comp ising
20 indi iduals (20.0%), a inding ha was
s a is ically signi ican (p < 0.0001). In simila s udy
byZhang J e al. obse ed a con inuous inc ease in
he incidence o inguinal, emo al, and abdominal
he nias among olde adul s om 1990 o 2021, wi h
a no able ise in cases among hose aged 60 and
abo e [5].
We ound ha in ou s udy, he male popula ion was
highe , wi h 68 pa ien s (68.0%) compa ed o 32
emales (32.0%), in a male- o- emale a io o 2.1:1;
howe e , his di e ence was s a is ically signi ican
(p < 0.0001). In o he s udy by Za okos a M e al.,
whe e 280 males (68.6%) and 128 emales (31.4%)
we e epo ed in a coho o 408 pa ien s unde going
inguinal he nia epai [6].
We ound ha abdominal pain was he uni e sal
p esen ing symp om in all 100 pa ien s (100%),
ollowed by omi ing in 81 pa ien s (81%),
abdominal dis ension in 67 pa ien s (67%), and
obs ipa ion in 52 pa ien s (52%), highligh ing hei
impo ance in iden i ying in es inal obs uc ion.
Clinical signs such as bowel sounds we e p esen in
79 pa ien s (79%), ballooning on digi al ec al
examina ion in 53 pa ien s (53%), and isible
pe is alsis in 10 pa ien s (10%), suppo ing he
clinical diagnosis. Obs uc ed he nia was he mos
equen diagnosis in 35 pa ien s (35%), ollowed by
adhesions in 18 pa ien s (18%), g ow hs in 14
pa ien s (14%), sigmoid ol ulus in 12 pa ien s
(12%), ileal s ic u es/TB in 8 pa ien s (8%),
in ussuscep ion in 6 pa ien s (6%), small gu
gang ene in 3 pa ien s (3%), and o he causes in 4
pa ien s (4%). Among he nia ypes, inguinal he nia
p edomina ed in 29 pa ien s (82.8%), ollowed by
incisional he nia in 3 pa ien s (8.6%), emo al he nia
in 2 pa ien s (5.7%), and epigas ic he nia in 1
pa ien (2.9%). These indings we e highly
s a is ically signi ican (p < 0.0001).In simila s udy
by Baj acha ya S e al. obse ed ha abdominal pain
(93%), omi ing (74%), and abdominal dis ension
(65%) we e he mos common p esen ing symp oms
in pa ien s wi h in es inal obs uc ion, which aligns
wi h ou indings.[7] We obse ed ha he mos
common ea men in ou s udy was educ ion and
he nia epai , pe o med in 30 pa ien s (30%),
ollowed by adhesiolysis in 17 pa ien s (17%),
esec ion and anas omosis in 13 pa ien s (13%), and
sigmoidec omy in 11 pa ien s (11%). Less
equen ly pe o med p ocedu es included igh
hemicolec omy in 5 pa ien s (5%), Ha man
p ocedu e in 4 pa ien s (4%), ileos omy in 4 pa ien s
(4%), and double ba el ileos omy in 3 pa ien s
(3%), while o he p ocedu es accoun ed o 13
pa ien s (13%). These ea men pa e ns we e
highly s a is ically signi ican (p < 0.0001). In
simila s udy by 3. Baj acha ya S e
al.obse ed ha he nia epai was he mos
equen ly pe o med p ocedu e (28%), ollowed by
adhesiolysis (20%) and esec ion wi h anas omosis
(15%) among pa ien s wi h in es inal obs uc ion
[7]. We ound ha he majo i y o pa ien s, 64
(64%), expe ienced no pos ope a i e complica ions.
Wound in ec ion occu ed in 20 pa ien s (20%),
wound gaping in 10 pa ien s (10%), and dea h was
epo ed in 6 pa ien s (6%). These ou comes we e
highly s a is ically signi ican (p < 0.0001). In
simila s udy by Le ST, e al. (2025) highligh ed
pos ope a i e complica ion a es in in es inal
obs uc ion su ge y [8]
Conclusion
We concluded ha , acu e in es ine blockage is s ill a
majo su gical eme gency ha p ima ily a ec s
pa ien s be ween he ages o 50 and 59, wi h a small
male p eponde ance. The mos common p esen ing
symp om was abdominal discom o , which was
o en accompanied by omi ing, dis ension, and
cons ipa ion. The diagnosis was made easie by
clinical examina ion esul s including bowel sounds
and ballooning on digi al ec al examina ion.
Adhesions and obs uc ed he nias we e he main
causes, wi h inguinal he nias being he mos
common o m. The mos equen su gical
echniques we e educ ion and he nia epai , wi h
adhesiolysis and esec ion added whe e necessa y.
Al hough wound in ec ion, wound gaping, and
mo ali y happened in a small pe cen age o pa ien s,
he majo i y expe ienced an une en ul
pos ope a i e cou se. In o de o maximize esul s
o pa ien s wi h in es inal obs uc ion, hese da a
highligh he signi icance o ea ly de ec ion, p omp
su gical in e en ion, and ca e ul pe iope a i e ca e.
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