Spectrum and Surgical Outcomes of Intestinal Obstruction in Adults at a Tertiary Care Center

Background: Intestinal obstruction is a common surgical emergency in adults with varied etiologies and outcomes. In India, causes such as adhesions, hernias, and tuberculosis are more prevalent than in North countries. This retrospective study evaluated the spectrum of adult intestinal obstruction at a tertiary care center in Gujarat over a year. Demographic patterns, causes, surgical management, and postoperative outcomes were analyzed. The aim was to identify trends that could improve clinical management and reduce morbidity and mortality. Material and Methods: This retrospective observational study was conducted at a tertiary care hospital in Gujarat, India. Ethical approval was obtained from the institutional review board. We reviewed medical records of adults aged 18 years and above admitted with intestinal obstruction over a year. Inclusion criteria encompassed confirmed cases via clinical examination, imaging (X-ray, CT scan), and surgical findings. Exclusion criteria included pediatric cases, chronic obstructions without acute symptoms, and non-surgical management. Data collected included demographics, symptoms, etiology, surgical procedures, complications, and outcomes. Statistical analysis was performed using SPSS software. Results: Of the 150 patients, 92 (61.3%) were male, with a mean age of 52.4 years. Small bowel obstruction predominated (68%), primarily due to adhesions (42%), followed by hernias (28%), malignancy (15%), and tuberculosis (10%). Large bowel cases were mainly neoplastic (5%). Surgical intervention was required in 128 (85.3%) patients, with adhesiolysis (45%), hernia repair (25%), and resection-anastomosis (20%) being common procedures. Postoperative complications occurred in 32 (21.3%) cases, including wound infections (12%) and anastomotic leaks (5%). Mortality was 8 (5.3%), linked to delayed presentation and comorbidities. Recovery was favorable in 118 (78.7%) patients, with a mean hospital stay of 7.2 days. Conclusion: This study underscores adhesions as the leading cause of intestinal obstruction in our setting, reflecting global trends but with a notable burden from hernias and tuberculosis. Timely surgical intervention improved outcomes, though complications remain a challenge. Enhanced preventive measures, such as early hernia repairs and adhesion barriers, could reduce incidence. Future multicenter studies are recommended to validate these findings and optimize protocols.