Acute Mechanical Bowel Obstruction among Adults Seen at the Ladoke Akintola University of Technology Teaching Hospital in Nigeria.

Background: Acute mechanical bowel obstruction (AMBO) is one of the common life threatening emergencies globally. This study was aimed at determining the pattern of causes of acute mechanical bowel obstruction in adult seen at the Ladoke Akintola University of Technology Teaching Hospital, Osogbo.
Methods: This was a prospective study of all adult patients with clinical, radiological and intra-operative features of acute mechanical bowel obstruction between June 2007 and June 2014, in the Ladoke Akintola University of Technology Teaching Hospital, Osogbo.
Results: A total of 126 adult patients with the diagnosis of acute mechanical bowel obstruction were enrolled in the study. The patients’ ages ranged between 15 and 87 with a mean of 44.5 ± 2.1 (SD) years. The male to female sex ratio was 1: 1. Adhesions and bands accounted for 81 (64.3%) of the cases. Obstructed /strangulated hernia were responsible for 20 (15.9%) of the patients. Other causes included volvulus in 25 (19.8%), bowel tumors (6.3%), anastomotic strictures (5.6%), anastomotic strictures (3.2%), intussusceptions (3.2%) and faecal impaction (1.6%). The overall mortality was 10.3%.
Conclusion: Post-operative adhesion is the most common cause of acute mechanical intestinal obstruction with majority of these resolving on conservative management. The reduced incidence of obstructed/ strangulated external hernia in our environment is perhaps due to increased patients’ awareness with many patients now presenting in the outpatient clinic with uncomplicated hernia.