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Etiological Spectrum of Sub Acute Intestinal Obstruction in Gastroenterology Practice in India
 
Sudhir Maharshi, Dilip Singh Mudgal, Shyam Sunder Sharma, Kamlesh Kumar Sharma, Bharat Sapra, Rupesh Pokharna, Sandeep Nijhawan
Department of Gastroenterology, SMS Medical College and Hospitals, Jaipur, India. 


Corresponding Author
:
Dr. Sudhir Maharshi
Email: sudhir.maharshi@gmail.com


Abstract

Background: Regional as well as worldwide variations in the pattern of sub-acute intestinal obstruction (SAIO) from time to time are well documented, but most of these studies are from surgical departments.There is a lack of data on etiological spectrum of SAIO in patients who are consulting in gastroenterology department.
Aims: The aim was to study the etiological, clinical profile and treatment outcomesof SAIO patients who were presented to gastroenterology department.
Methods: This prospective descriptive study was conducted in the department of gastroenterology,SMS medical college and hospitals, Jaipur between August 2019 to July 2021. All the patients with clinical diagnosis of SAIO were consecutively enrolled. Data related to demography, clinical features, laboratory parameters, radiological imaging, histology and treatment outcomes were analyzed.
Results: A total of 224 patients (age 43.7±13.7 years, BMI 17.1±3.1kg/m2, 57.14% male) were studied. Etiology of SAIO was neoplastic 76(33.92%), tuberculosis 64(28.57%), benign stricture with non-specific histology 30(13.39%) and adhesions in 23(10.27%) patients. Surgical treatment was required more in neoplastic (65.8% vs 34.2%; p=0.02) and benign stricture with non-specific histology (93.33% vs 6.66%; p=0.001) while conservative treatment including antitubercular therapy and endoscopic dilatations if required was more successful in tubercular etiology (73.43% vs 26.57%, P=0.04). 
Conclusion: Neoplasm is the most common cause of SAIO in gastroenterology practice, followed by tubercular, benign stricture with non-specific histology and adhesions. Majority of tubercular patients can be treated with conservative treatment while surgical management is needed more in neoplastic and benign stricture with non-specific histology.