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Mechanical Bowel Obstruction--Changes in Aetiology over the Past 145 Years: A Single Centre Retrospective Cohort
M Pędziwiatr1, P Budzyński, M Stanek
12nd Department of General Surgery, Jagiellonian University, Kraków, Poland.
Introduction:
Mechanical bowel obstruction (MBO) remains one of the most common abdominal surgical emergencies. The aetiology of MBO depends on the population demographics and period of time in which a given population was studied. We are presenting the results of an analysis covering 145 years of observations based on patients operated in our department.
Methods:
The single centre retrospective analysis included 1825 patients with MBO. They were divided into 4 groups depending on the years in which they were treated : group 1 (1868-1898), group 2 (1956-1970), group 3 (1987-1999), group 4 (2000-2013). The analysis covered the sex distribution, the mean age of patients versus the life expectancy and changes in MBO aetiology in every period.
Results:
We noticed an increase in the mean age and the growing divergence between life expectancy. Additionally, an increasing percentage of women were observed. There were also significant changes in the aetiology. An increase in MBO caused by cancer was observed. The rate of strangulated hernias doubled in the second period of time, and then it gradually decreased. Intestinal volvulus was common in the first period and became one of the rarest causes of MBO in the subsequent periods. MBO due to adhesions remained at the same level. It became, however, the most common cause in the last period.
Conclusions:
Within nearly 150 years significant changes occurred in the demographics and aetiology of MBO. Currently, the most common cause is peritoneal adhesions after previous surgeries. Although our results represent a single centre experience, they may reflect changing patterns in MBO in the Polish population over time.
Insights
Over 145 years, mechanical bowel obstruction (MBO) demographics shifted, with older patients and more women. Peritoneal adhesions became the leading cause of MBO, surpassing hernias and volvulus.
Area of Science:
- Gastroenterology
- Surgical Emergencies
- Abdominal Surgery
Background:
- Mechanical bowel obstruction (MBO) is a frequent surgical emergency.
- Etiology of MBO varies by population demographics and study period.
- This study analyzes 145 years of MBO patient data.
Purpose of the Study:
- To investigate demographic shifts in MBO patients over 145 years.
- To identify changes in the causes of MBO over time.
- To compare MBO etiology across different historical periods.
Main Methods:
- Retrospective analysis of 1825 MBO patients from a single center.
- Patients divided into four groups based on treatment year (1868-2013).
- Analysis of sex distribution, mean patient age, life expectancy, and MBO etiology.
Main Results:
- Increased mean patient age and widening gap with life expectancy.
- Growing proportion of female patients.
- Shift in MBO etiology: increased cancer-related obstruction, initial rise then fall in strangulated hernias, decreased intestinal volvulus, and adhesions becoming the most common cause.
Conclusions:
- Significant changes in MBO demographics and etiology observed over nearly 150 years.
- Peritoneal adhesions are now the primary cause of MBO.
- Findings may reflect broader trends in the Polish population, despite single-center data.
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