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Changing pattern of acute intestinal obstruction in Accra
1Department of Surgery, University of Ghana Medical School, Accra.
West African Journal of Medicine
|April 1, 1993
Summary
Strangulated external hernias and adhesions are the leading causes of intestinal obstruction in Accra. While hernia incidence decreased, adhesive obstruction rose, with no change in overall mortality but improved rates for volvulus and adhesive obstruction.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Public Health
Background:
- Intestinal obstruction remains a significant surgical challenge globally.
- Understanding regional etiological trends and outcomes is crucial for effective management.
- Accra, Ghana, faces specific challenges related to common causes of intestinal obstruction.
Purpose of the Study:
- To analyze the etiological patterns of intestinal obstruction in Accra.
- To evaluate changes in the relative incidence of common causes over a two-year period.
- To assess mortality rates and resection trends associated with different causes.
Main Methods:
- Retrospective case series analysis.
- Data collected over a two-year period (January 1987 - December 1988).
- Inclusion of 552 cases of intestinal obstruction.
Main Results:
- External hernias (59.8%) and adhesions (21.0%) were the most frequent causes.
- External hernias incidence decreased, while adhesive obstruction incidence increased.
- Overall mortality remained 9.4%; inguinal hernia mortality was 4.9%.
- Significant improvement in volvulus mortality; slight improvement in adhesive obstruction mortality.
- Overall resection rate increased from 12.7% to 17.6%.
Conclusions:
- While hernias and adhesions persist as primary causes, their relative incidence is shifting.
- Mortality from specific causes like volvulus has improved, despite an increased resection rate.
- Continued monitoring of epidemiological trends in intestinal obstruction is warranted.