Trends in Mechanical Intestinal Obstruction: A 30‑Year Comparative Analysis Between Developing and Developed Nations

Area of Science:

• Gastroenterology
• Surgical Oncology
• Epidemiology

Background:

• Mechanical intestinal obstruction (MIO) is a critical global surgical emergency.
• Etiological patterns of MIO historically differed between developed and developing nations.
• Recent trends and drivers of MIO etiology require updated investigation.

Purpose of the Study:

• To analyze 30-year trends in MIO etiology and outcomes in Jordan.
• To compare Jordanian MIO data with global trends to assess pattern convergence.
• To identify the evolving causes and outcomes of MIO.

Main Methods:

• Retrospective cohort study of MIO patients (2020-2023) at a Jordanian tertiary center.
• Systematic literature review of MIO etiologies in developed and developing nations (pre- and post-2000).
• Analysis of demographics, management, outcomes, and mortality, using chi-square and t-tests.

Main Results:

• Postoperative adhesions emerged as the leading cause of MIO (64% in 2023, up from 25% in 1993).
• Malignancy (20%) and hernias (5%) were subsequent causes.
• Global data post-2000 confirmed adhesions as the predominant MIO etiology in both developed and developing countries.

Conclusions:

• Adhesions are now the leading global cause of MIO, linked to increased surgical access and aging populations.
• Converging etiological trends between developed and developing nations may reflect socioeconomic advancements.
• Urgent need for standardized global reporting and effective adhesion prevention strategies.