ABSTRACT

Background: Small bowel obstruction (SBO) sounds a common emergency presentation but seemingly has a high morbidity, mortality and also its tendency to occur again is high.

Aim: To compare the results of patients treated surgically within and after 24 h of admission.

Methods: A comparative study was done on patients with small bowel obstruction admitted to surgery department of Jinnah post graduate medical center, Karachi Pakistan from 1st January 2017 to 31st December 2018. Of all the admissions, data of SBO patients was collected in detail. Collected data included age, gender, surgical diagnosis, co-morbid conditions, number of admissions, procedure performed, duration of procedure and wither operated in <24h or>24h of admission.

Results: During the study period among 110 patients who got admitted with small bowel obstruction, 100 went through surgery (surgical group) and 10 were kept for conservative treatment. 0ut of 100 patients 52 got operated within 48 h of admission (Surgical Group 1) while 15 were operated after 24h of admission (surgical Group 2). Among gp1 4 patients expired while from Group 2, 9 expired within 1 week of surgery. We kept the same Basic characteristics between the two groups. One-year mortality and recurrence from hospital discharge date was not notably different between the comparison groups (age- and sex-adjusted HR, 1.1; 95 % CI, 0.6–2.1). 80 patients actually reported for follow up and were evaluated.

Conclusions: The immediate mortality of patients operated with in 24 hrs of admission was significantly lower than those operated beyond 24 h. Recurrence of obstructive symptoms, hospitalizations with same symptoms of SBO and one-year survival and mortality was somewhat the same among both groups.

Keywords: Small bowel obstruction, recurrence, appendicectomy, hysterectomy