The Pattern of intestinal Obstruction at Kibogola Hospital, a Rural Hospital in Rwanda

Background : Intestinal obstruction can be caused by many conditions that vary from country to country, from area to area within the same country and at different times. The outcome of management of the condition may be a good indicator of how well a country’s surgical services are doing. The causes and the outcome of intestinal obstruction were studied in a rural Rwandan hospital.
Methods : This was a retrospective study from January 2003 to December 2007. Data analyzed from patients’ records included age, sex, duration of symptoms, operative diagnosis, treatment and outcome of management.
Results : There were 105patients with intestinal obstruction seen during the study under review. Males accounted for 72.4% of cases. The ages ranged from 1month to 80 years with a mean of 31.8 years. The average duration of symptoms was 3.5 days.The leading cause of intestinal obstruction was obstructed/strangulated external hernias in 41(39.0%) of patients and was followed by intussusception in 22(21.0%). Adhesions were third with 18(17.1%) patients. Sigmoid volvulus occurred in only 11(10.5%) patients. Forty (38.1%) patients underwent intestinal resection and anastomosis. The hospital stay ranged between 1 and 36days with a mean stay of 10.4days. The overall mortality rate was 6.7%.
Conclusion : Good surgical services in the community could reduce the intestinal obstruction related mortality. External hernias could be electively repaired before they get obstructed.