Intestinal obstruction is a gastro-intestinal condition in which digested material is prevented from passing normally through the bowel. It is inability of forward propulsion of intestinal content and the second causes of acute abdomen next to acute appendicitis. (1–4).
Globally, intestinal obstruction accounts for approximately 15 percent of all visits of emergency department for acute abdominal pain. The occurrence and etiology of bowel obstruction throughout the world varied depending on ethnicity, age group, dietary habits, and geographic location, among other factors (7, 8). In the United States, 5% of all large bowel obstructions (LBOs) are caused by colonic volvulus, making it the third most common cause of LBO after cancer and diverticular disease in adult patients. In this country over 300,000 patients are estimated to undergo surgery to treat adhesion-induced small bowel obstruction annually. In some developing countries, including India, Pakistan and Brazil, sigmoid volvulus alone has been reported to account for 20–30% of all intestinal obstructions (6).
According to different study, colorectal cancer is responsible for 60–70% of all large bowel obstructions, while diverticulitis and volvulus account for the majority of the remaining 30% worldwide. Although possible, abdominal wall hernias and adhesions rarely cause a true, isolated large bowel obstruction. In contrast, small bowel obstruction in most advanced western societies is caused most commonly by adhesions, neoplasms, or abdominal wall hernias. In Ethiopia sigmoid volvulas accounts for over 54% of intestinal obstructions (5, 6).
Studies in Attat and Ayder Referral Hospital, Mekelle in Ethiopia reported that the magnitude of intestinal obstruction accounts for 30 and 42 percent of all emergency surgically treated patients respectively(9–11). A cross sectional study conducted in Arbaminch general Hospital in southern part of Ethiopia also reported that the overall magnitude of intestinal obstruction was 40.60% from all emergency surgically treated patients (12).
It is one of the serious surgical emergencies and associated with high mortality and morbidity throughout the World. Its mortality rates range from up to 3% for simple obstructions to as much as 30% when there is vascular compromise or perforation of the obstructed bowel, depending on the clinical setting and other related or unrelated co morbidities. In addition, bowel obstruction is frequently a recurrent problem, adding to the overall morbidity of an operation or successful non operative management(6).
Management e of intestinal obstruction was improved since the development of more sophisticated diagnostic tests and imaging machine, but still the condition remains major public health problem especially in developing countries (11, 13, 14). It is the challenging problem which is determined by many patients ‘related and clinical related factors like surgical site infection, wound dehiscence, leakage, pneumonia and sepsis. Many of this unfavorable outcome could be minimized if the factors related with surgical management outcome of intestinal obstruction is predetermined and all the necessary action is taken to prevent the causes associated with it before and after the procedure(15, 16).
Surgical management is quoted ‘evidence based surgical treatment and a concept on which surgical health professional relied on the updated and well evidenced data to recommend for the patients rightfully on plugging of disease. Physicians are not only expected to perform evidence-based procedure but also, they must understand about the postoperative recovery, the impact of quality of procedure and expected functional outcome. (16).
Though studies have been done to assess the prevalence and causes of intestinal obstruction in Ethiopia, the condition related with the magnitude and determinants of treatment outcome among surgically treated patients with intestinal obstruction is largely remain unstudied especially in southern part of Ethiopia. Hence, the aim of this study was to assess magnitude and determinants of treatment outcome among surgically treated patients with intestinal obstruction at public hospitals in Wolayita Zone, Southern Ethiopia.