Comprehensive Evaluation of Symptoms and Risk Factors in Adhesive Small Bowel Obstruction

Abstract

Introduction: Adhesive small bowel obstruction (ASBO) is a significant condition often encountered in surgical emergencies, characterized by the blockage of the small intestine due to fibrous bands called adhesions. These adhesions typically form after abdominal surgeries, leading to substantial morbidity, prolonged hospital stays, and increased healthcare costs. Understanding the symptoms and risk factors associated with ASBO is crucial for enhancing patient outcomes and developing effective prevention and management strategies. Material & Methods: This prospective observational study was conducted at the Department of General Surgery, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, from August 1, 2022, to January 31, 2024. Patients aged 18 years and older with an episode of adhesive small bowel obstruction were included, excluding those with large bowel obstruction, incarcerated hernia, early post-operative small bowel obstruction, inflammatory bowel disease, radiationinduced fibrosis, and peritoneal carcinomatosis. Data were collected through patient histories, clinical examinations, and investigations, and analyzed using SPSS version 23. The sample size was calculated to include 60 patients, accounting for a 10% dropout rate. Results: The study found that the majority of ASBO patients were between 18-29 years (25.4%) and 45 to 59 years (23.7%), with a predominance of females (55%). Diabetes Mellitus (DM) was the most common past medical condition (30.0%), followed by DM with Tuberculosis (25.0%). Alcohol consumption (36.7%) and combined smoking and alcohol use (31.7%) were also prevalent. Systemic examination revealed that 45.0% had tenderness, while 51.6% were within normal limits. Abdominal pain was a common symptom in both operated (63.3%) and non-operated (35.0%) patients. Significant associations were found for age (adjusted OR 1.79, p = 0.045) and tenderness (adjusted OR 0.75, p = 0.036). Conclusion: The study highlighted the demographic and clinical characteristics of ASBO patients, emphasizing the importance of recognizing risk factors such as age, medical history, and lifestyle habits. Identifying these factors can aid in better managing and preventing ASBO, ultimately improving patient care and reducing healthcare burdens. The findings underscore the necessity for targeted interventions and refined surgical techniques to minimize adhesion formation and subsequent bowel obstructions.