Intestinal Obstruction in Adult Saudi Arabian Population: A Review of 754 Patients

The etiology of acute intestinal obstruction varies between countries. The objective was to study the causes of intestinal obstruction and the management outcomes in local set up in a secondary care hospital in Eastern Saudi Arabia. This is a descriptive retrospective study containing analysis data in a 20-year period between years 1990 and 2010 of patients admitted in general surgery ward, with the diagnosis of intestinal obstruction. Of the 754 consecutive patients included in the study, 498 (66%) presented with small bowel and 256 (34%) with large bowel obstruction. The study group was composed of 54.4% males and the age ranged from 18 to 85 years with the mean age of 35.8. The mean duration of symptoms was 2.4 days, ranging from 4 hours to 9 days. Absence of passage of flatus (92%) and/or feces (84%), abdominal pain (65.7%) and abdominal distension (73.6%) were the most common symptoms and physical finding, respectively. The main causes of obstructive were adhesions (59.6%), large bowel cancer (22.6%), incarcerated hernias (8.3%), and fecal impaction (3.6%), small bowel tumors (2.6%), pseudo-obstruction (1.8%), intussusceptions (1.3%), and others (0.2%). Sixty-eight percent were treated conservatively and (32%) were operated. The morbidity was 17.25% while mortality was 2.5%. In conclusion, this is a study of the surgical experience of intestinal obstruction in Saudi Arabia over long period (20 years). The causes and pattern of intestinal obstruction seen is more similar to those reported from Asia.