Co esponding au ho : Suega P. Inunduh.
Copy igh © 2025 Au ho (s) e ain he copy igh o his a icle. This a icle is published unde he e ms o he C ea i e Commons A ibu ion License 4.0.
Cha ac e is ics o in es inal obs uc ion seen a a Te ia y Hospi al in No h-Cen al,
Nige ia
Suega P. Inunduh 1, *, Hussaini B. Micah 2, Alex T. Io bo 2, Lupe E. To -Musa 2 and An hony A. Amu a 2
1 Depa men o Ana omy/Su ge y, Facul y o Basic Medical Sciences, Ve i as Uni e si y, Abuja, Nige ia.
2 Depa men o Su ge y, Fede al Medical Cen e, Maku di, Nige ia.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(01), 3784-3790
Publica ion his o y: Recei ed on 18 Ma ch 2025; e ised on 23 Ap il 2025; accep ed on 26 Ap il 2025
A icle DOI: h ps://doi.o g/10.30574/wja .2025.26.1.1417
Abs ac
In oduc ion: In es inal obs uc ion is a e y common clinical condi ion encoun e ed by he Gene al su geon wi h a
e y high mo bidi y and mo ali y. While adhesions we e conside ed he commones cause in he de eloped coun ies
and ex e nal he nias in mos de eloping coun ies o he wo ld, he e has been global a ia ion in ae iology ac oss
egions and e en wi hin egions. Ou aim is o s udy he ae iology, clinical p esen a ion and ea men in ou cen e and
compa e o o he s udies locally and in e na ionally.
Ma e ials and me hods: This is a e ospec i e s udy ca ied ou a he Fede al Medical Cen e Maku di, a Te ia y
hospi al in Benue s a e, no h cen al, Nige ia be ween 2010 and 2014. We e ospec i ely e ie ed and analysed he
da a o all pa ien s, o all age g oups who had lapa o omy o in es inal obs uc ion a he Su ge y depa men .
Resul s: O a o al o 69 pa ien s who had lapa o omy o in es inal obs uc ion, males we e 42(60.9%) and emales
27(39.1%). The peak ages we e 1-10 yea s (21.7%) and 21-30 yea s (23.2%). The commones complain s we e
abdominal pain 65(94.2%), abdominal swelling 43(62.3%), omi ing 40(58%) cons ipa ion 25(36.2%) and e e
24(34.8%). Only 13(18.8%) p esen ed wi hin 72 hou s, 17(24.6%) wi hin 4-6 days while majo i y 32(46.3%) p esen ed
be ween 1-3 weeks. P e ious abdominal sca was seen in 22 (31.9%), while 47 (68.1%) had no e idence o a p e ious
sca . The commones causes o in es inal obs uc ion we e adhesions 24 (34.8%), Typhoid ileal pe o a ion 17 (24.6%),
in ussuscep ion 9 (13.0%) and colonic umou 7 (10.1%). The e was only 1 (1.4%) case o s angula ed he nia.
Conclusion: Adhesions and Typhoid ileal pe o a ions a e leading causes o in es inal obs uc ion in ou en i onmen
wi h la e p esen a ion o case, a common ea u e. P e en i e measu es should be encou aged.
Keywo ds: Cha ac e is ics; Ae iology; In es inal Obs uc ion; Clinical P esen a ion; Lapa o omy
1. In oduc ion
In es inal obs uc ion is any impedimen in he p opulsion and passage o aeces, liud o gas om p oximal pa o he
gas oin es inal ac o he dis al pa o i , leading o s asis and bowel dis ension wi h consequen de angemen s in
luid and elec oly e imbalances. I is one o he commones in a-abdominal p oblems con on ing he gene al su geon
in his/he su gical p ac ice.
I can be classi ied as dynamic (mechanical) o adynamic (pseudo-obs uc ion). Dynamic obs uc ion is cha ac e ized
by blockage o bowel (luminal, mu al, ex a-luminal), esul ing o inc ease in es inal con ac ili y as a physiologic
esponse o elie e obs uc ion. Pseudo obs uc ion is cha ac e ized by absence o in es inal con ac ili y (1).
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(01), 3784-3790
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Globally p e alence and inciden a es inc eased by 56.9% and 86.67% om 1990-2019 espec i ely (2). Abou 3.2
million cases o bowel obs uc ion occu ed in 2015 wi h 264,000 dea hs (3).
I s ae iology a ies widely be ween and wi hin geog aphic egions, wi h gende , age and ime (4). In mos coun ies o
A ica, i accoun s o a signi ican p opo ion o mo bidi y which a ies om egion o egion (5). The cos o ea men
is also eno mous, anging om 16,305 Eu os o o e 200 Eu os o ope a i e and non-ope a i e admissions (6), which
is beyond many in limi ed- esou ce se ings o sub-Saha an A ica.
The aim o his s udy is o e iew he ae iology, pa e ns o p esen a ion and ea men o compa e wi h o he cen es
locally and in e na ionally.
2. Ma e ials and Me hods
This was a e ospec i e s udy in which we e ospec i ely e iewed he medical eco ds o pa ien s who we e admi ed
and ea ed wi h he diagnosis o in es inal obs uc ion a Fede al Medical Cen e, Maku di, Nige ia be ween 2010 and
2014.
2.1. Inclusion c i e ia
All pa ien s, o all age g oups who we e admi ed wi h a diagnosis o In es inal obs uc ion and ope a ed a he hospi al
wi hin he s udy pe iod.
2.2. Exclusion c i e ia
• Pa ien s who we e admi ed wi h acu e abdominal pain o Medical o Gynaecological o igin.
• Da a was analyzed using Mic oso excel and SPSS e sion 26.
3. Resul s
This e ospec i e e iew in ol ed 69 pa ien s o all age g oups diagnosed wi h in es inal obs uc ion and had
lapa o omy du ing he s udy pe iod. The e was a male p edominance, 42(60.9%). The age ange was om 1 mon h o
90 yea s, wi h wo peaks a 1-10 yea s 15(21.7%) and 21-30 yea s 16(23.2%) espec i ely. S uden s we e he
p edominan social class in ol ed 31(51.7%), ollowed by a me s 13(21.7%).
Table 1 Socio-demog aphic da a (age, gende , occupa ion)
Age
F equency
Pe cen
1-11 mon hs
4
5.8
1-10 yea s
15
21.7
11-20 yea s
9
13.0
21-30 yea s
16
23.2
31-40 yea s
9
13.0
41-50 yea s
3
4.3
51-60 yea s
4
5.8
61-70 yea s
6
8.7
71-80 yea s
2
2.9
81-90 yea s
1
1.4
To al
69
100
Gende
F equency
Pe cen
male
42
60.9
Female
27
39.1
To al
69
100
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(01), 3784-3790
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Occupa ion
F equency
Pe cen
S uden s
31
44.9
Fa me s
13
18.8
T ade s
5
7.2
House Wi es
4
5.8
Ci il Se an s
4
5.8
A med o ces
2
2.9
O he s
10
14.5
To al
69
100
The commones p esen ing complain s we e abdominal pain 65(94.2%), abdominal swelling 43 (62.3%), omi ing 40
(58.0%), cons ipa ion 25(36.2%) and e e 24(34.8%) and le inguinal swelling 1(1.4%).
Table 2 P esen ing complain s in descending o de
Complain
F equency
Pe cen
Abdominal Pain
65
94.2
Abdominal swelling
43
62.3
Vomi ing
40
58.0
Cons ipa ion
25
36.2
Fe e
24
34.8
Bloody S ool
7
10.1
Jelly S ool
1
1.4
Headache
1
1.4
Le Inguinal swelling
1
1.4
Only 13(18.8%) p esen ed wi hin 72 hou s, 17 (24.6%) p esen ed wi hin 4-6 days, while majo i y 32 (46.3%) p esen ed
be ween 1-3 weeks.
Table 3 Du a ion o symp oms be o e p esen a ion
Du a ion o symp oms
F equency
Pe cen
1-3 days
13
18.8
4-6 days
17
24.6
1 week
15
21.7
2 weeks
13
18.8
3 weeks
4
5.8
1 mon h
3
4.3
2 mon hs
1
1.4
3 mon hs
1
1.4
>3 Mon hs
2
2.9
To al
69
100
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(01), 3784-3790
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On examina ion o he abdomen, 22 (31.9%) had an abdominal sca om p e ious su ge y, while 47(68.1%) had no
sca om p e ious abdominal su ge y.
Table 4 In a-Ope a i e Findings and a e o Resec ion and Anas omosis
In a-Ope a i e Finding
F equency
Pe cen
Adhesions
14
41.2
Colonic umou
7
20.6
Sigmoid Vol ulus
5
14.7
Typhoid Ileal Pe o a ion
5
14.7
In ussuscep ion
3
8.8
To al
34
100
The commones cause o in es inal obs uc ion was adhesions 24 (34.8%), ollowed by pe i oni is seconda y o ileal
pe o a ion 17 (24.6%), in ussuscep ion 9 (13.0%) and colonic umou 7 (10.1%). The e was only 1 (1.4%) case o
s angula ed he nia.
Table 5 In a-ope a i e Findings and equency o esec ion and anas omosis
Cause
F equency
Pe cen
Adhesions
24
34.8
Typhoid ileal pe o a ions
17
24.6
In ussuscep ion
9
13.0
Colonic umou s
7
10.1
Sigmoid Vol ulus
6
8.7
S eno ic in es ines
2
2.8
Rup u ed appendix
1
1.4
Pe o a e S omach ulce
1
1.4
S angula ed he nia
1
1.4
Blun T auma
1
1.4
To al
69
100
4. Discussion
In ou e iew o 69 cases wi hin he s udy pe iod, i was ound ha in es inal obs uc ion occu ed p edominan ly in
males (60.9%). This inding is in con o mi y wi h hose o ([7, 8, 9).
Ou pa ien s a isk o in es inal obs uc ions demons a ed wo age peaks, 1-10 yea s wi h a mean o 5.5 and 21-30
yea s wi h a mean o 25.5 yea s. The peak age o 21-30 yea s ag ees wi h simila indings by (10). This inding e lec s
he p edominan ly younge age o he Nige ian popula ion.
The commones cause o in es inal obs uc ion in ou s udy was adhesions 24 (34.8%), ollowed by pe i oni is
seconda y o yphoid ileal pe o a ion 17 (24.6%), in ussuscep ion 9 (13.0%) and colonic umou 7 (10.1%). The
indings o adhesions as he commones cause o in es inal obs uc ion is in con o mi y wi h o he indings in ou egion
and beyond, ([7, 11, 12, 9, 13, 14, 15, 16). The ising cases o adhesi e in es inal obs uc ion in ou egion may e lec
inc easing heal h seeking beha iou s and also inc ease in he numbe o lapa o omies pe o med. Howe e , i was
no ed ha only 22 (31.9%) had an abdominal sca om p e ious su ge ies while 47 (68.1%) had no . I he e o e means
ha some o he adhesions would ha e been as a esul o subclinical pe i oni is om o he in ec i e causes, congeni al
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(01), 3784-3790
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o epea ed auma. We no ed ha pe i oni is seconda y o yphoid ileal pe o a ions was he second cause o bowel
obs uc ion 17 (24.6%). This e lec s he gap in he a ailabili y o po able wa e in many sub-Saha an A ican coun ies.
Majo i y o he cases o in ussuscep ion occu ed in child en be ween he ages o 1-10 yea s. Some esea che s ha e
ound a di e en ae iology o in es inal obs uc ion. U gessa e al; (17) ound in ussuscep ion as he leading cause in
Adama hospi al, E hiopia (30.9%), Okeny e al; (8), epo ed He nias (40.2%) as he commones cause in a u al hospi al
in Uganda,N akiyi u a and muka ugwi o (18) also epo ed s angula ed ex e nal he nias in a u al hospi al in Rwanda
as he commones cause(39.0%) o in es inal obs uc ion. Simila ly, Ahmad e al; (19) ound s angula ed he nias o be
he commones cause o in es inal obs uc ion (40%) in a dis ic hospi al, Wes Bengal, India, while Fekadu e al; (20),
in a sys ema ic e iew, ound small bowel ol ulus as he leading cause o in es inal obs uc ion in E hiopia while
sigmoid ol ulus was he leading cause o la ge bowel obs uc ion. These indings demons a e global a ia ion ac oss
egions and wi hin egions (4). Fu he s udies may e eal a ia ion be ween u ban and u al a eas wi hin he same
egion.
This s udy also demons a es he a i y o he nias in ou en i onmen cons i u ing jus 1.4% o he ae iological ac o s
o in es inal obs uc ion. This may be due o se e al easons, i s ly, he e a e many missiona y hospi als sca e ed
ac oss he u al a eas wi h many o he expe ienced hea e echnicians able o ix uncomplica ed he nias a a e y low
cos . Secondly ee medical ou eaches by poli icians ha e p o ided ample oppo uni ies o many people o ha e hei
he nias ixed elec i ely. The au ho has pa icipa ed in many o such ou eaches. Thi dly, i may be because o heal h
educa ion, inc ease awa eness o he bene i s o elec i e su ge ies be o e complica ion de elops, and las ly he e o s
o a ious non-go e nmen al o ganiza ions (NGOs) o inc ease access o su ge y in u al a eas.
I was also no ed ha majo i y o he pa ien s p esen ed la e o he hospi al. Only 13 (18.8%) o he pa ien s p esen ed
wi hin 72 hou s o onse o symp oms, 17 (24.6%) p esen ed wi hin 4-6 days, while majo i y 32 (46.3%) p esen ed
be ween 1-3 weeks. This inding con as o o he esea che s like (11), who ound ha a e age ime o p esen a ion
was 2-4 days, while (8) epo ed du a ion o symp oms o be 1-14 days wi h mean o 4 days and (18) epo ed a e age
du a ion o symp oms o be 3.5 days bu ag ees wi h ha o A lene e al; (21) whe e 50% p esen ed a e 72 hou s and
only 7.3% p esen ed wi hin 24 hou s.
Mos ou pa ien s had explo a o y lapa o omy as he main ea men op ion. Main in a-ope a i e ea men s we e
adhesiolysis, p ima y closu e o pe o a ions o wedge esec ions and in es inal esec ion and anas omosis, Ileos omies
e c. 34 (49.3%) o he pa ien s we e ea ed by esec ion and p ima y anas omosis while 35 (50.7%) did no . This high
a e o esec ion and anas omosis con o ms o ea lie epo s by (18) who also epo ed a esec ion and anas omosis
a e o (38.0%). This high a e o in es inal esec ion and anas omosis may e lec he la e p esen a ion o mos o he
pa ien s.
5. Conclusion
Adhesions a e no ed as he commones cause o in es inal obs uc ion in Maku di, no h-cen al Nige ia wi h pe i oni is
seconda y o yphoid ileal pe o a ion coming a close second and in ussuscep ion hi d. We no e unusually la e
p esen a ion and a high a e o in es inal esec ion and anas omosis and ecommend p e en i e measu es including
a oidance o indisc imina e lapa o omies and p o ision o sa e d inking wa e .
Compliance wi h e hical s anda ds
Disclosu e o con lic o in e es
None o he au ho s decla ed any con lic o in e es
S a emen o e hical app o al
The s udy was conduc ed in compliance wi h he ins i u ion’s e hical equi emen s.
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