Intestinal Obstruction at El Thowra Teaching Hospital, El Beida, Libya

Background: Intestinal obstruction is a condition that results in failure of the contents of the intestine to progress though the lumen of the bowel. The most common cause is a mechanical blockage resulting from adhesions, impacted faeces, tumour of the bowel, hernia, intussusception, volvulus, or the strictures of inflammatory bowel disease etc. obstruction may also be the result of pseudo obstruction or paralytic ileus. Intestinal obstruction is a common emergency condition, met at all levels of surgical management. The aim of our study was to determine the incidence, causes, presentations and management of intestinal obstruction at El Beida in the North Eastern part of Libya.
Methods: A retrospective study of intestinal obstruction was done of two years from 1^st January 2009 to 31^st December 2010 at El Thoura Teaching Hospital. Datas of the patients collected and analyzed including age, sex of the patient, clinical features, causes of obstruction, site of obstruction and type of the treatment offered with outcome.
Results: We analyzed 108 cases of intestinal obstruction in a span of two years from 1^st January 2009 to 31^st December 2010. In our series adhesions were the most common cause of intestinal obstruction. The most common causes of mechanical intestinal obstruction was adhesions which were post operative in 33.3% and non-operative adhesions in 2.8%. Other causes included faecal impaction in 19%, hernia in 18.5%, sigmoid volvulus in 6.5%, Crohn's disease in 2.8%, gall stone ileus and foreign body in 0.9%, Mesenteric vascular ischaemia accounted for 1.9%.
Conclusion: The scenario has been changing the trend of occurrence in recent years due to better surgical care. Postoperative adhesions were the most common cause of intestinal obstruction. Proper timely diagnosis and adequate treatment will have the best outcome, especially in case of Mesenteric vascular occlusion.