Bowel obstruction is a mechanical or functional obstruction of bowel that prevents the normal movements of products of digestions[1]. It occurs due to partial or complete interference with the forward flow of small or large intestinal contents. High quality surgical expertise coupled with sound clinical judgment and early surgery when needed will greatly improve survival[2, 3]. Bowel obstruction contributes 12 to 16% of acute abdomen in emergency[4]. More than 300,000 Patients admit per year and 30,000 deaths annually due to bowel obstruction in USA[5]. Globally 2.1 deaths per 100,000 patients due to bowel obstruction, 3.5 deaths per 100,000 in developed countries and 1.8 deaths in developing country[6]. Patients who have a history of abdominal distention, constipation, prior abdominal surgery, and abnormal bowel sounds may fall into the diagnosis of Bowel obstruction[5]. It remains common cause of acute abdomen that faced surgeons and still have high morbidity and mortality[7, 8].
Bowel obstruction occurs due to different causative agents. The most common causes was mechanical obstructions such as adhesion, hernia, volvulus, malignancy, carcinoma, intussusceptions, and fecal impaction[9, 10]. Among those causes mostly they are vary from state to state and also even differ area to area in the same state. Adhesion is the most common cause of small bowel obstruction in developed country while volvulus and hernia is common in developing country. The remaining less common cause of bowel obstructions is inflammatory bowel disease, mesenteric vascular occlusion, paralytic ileus, stricture, inflammatory tumor, gall stone, foreign body, ileocaecal TB and Koch’s abdomen[11–14].
Since BO mostly treats through surgery in emergency. It causes to complications after post operation, such as surgical site infection, septic shock, and pneumonia postoperatively[19]. Management of bowel obstruction depends largely upon early diagnosis, skillful treatment and managing the pathological effects of the obstruction. Clinical, radiological and operative findings put together can diagnose the obstruction of bowel. The morbidity and mortality rates regarding to bowel obstruction have decrease results from the introduction of new advanced diagnostic tests, fluid and electrolyte correction, more effective antimicrobials and surgical treatment, but the condition still remains a challenging surgical diagnosis. Resection, anastomosis intussusceptions milking, Hartman’s, hernia repair, volvulus Derotation and Mekels diverticulectomy were producers to treat bowel obstruction [3, 7, 21].
Bowel obstruction remains common surgical emergency in the surgical field worldwide. It was the main cause of surgical emergency which cause to high risk of mortality and morbidity in African. Despite advance surgical treatment of bowel obstruction magnitude of unfavorable treatment outcome of BO in Africa was high [23, 24]. In Ethiopia bowel obstruction is highly prevalent which cause to surgical emergency secondary to appendicitis and magnitude of mortality of bowel obstruction is high and still has a great problem nationally [25–28].
There are risk factors which contributes to mortality for patients who have BO and treated surgically like age, sex, duration of illness before treatment, length of hospital stay, co morbidity, procedure performed and intra operative finding[8, 26, 34, 39]. Even though morbidity and mortality due to bowel obstruction had different factors in the previous studies poorly explored[8]. It is worse in developing countries which lack health care facility, lack health care seeking behavior, these more serious the outcomes related to such like patients who present lately to hospital and cause to mortality. Even if increase medical services and have advance health professionals those who are well familiar with BO pathophysiology, increase infection prevention practice, and access of materials important for early diagnosis of bowel obstruction the problem is continue high. Littlie studies done in our country Ethiopia based on bowel obstruction treatment outcome on adult individuals even if its significantly associated with increased age [35].
Mortality after surgical treatment of bowel obstruction varies from area to area, change from time to time, and also age is significant factor for mortality due to bowel obstruction, it needs recurrent studies for the treatment outcome of bowel obstruction. Moreover variable which was not studied pervious included in this study. There are no publishing studies in the study area of northwest Ethiopia at Debre Markos comprehensive specialized hospital. So the main purpose of these studies is to full fill this gap and recommend accordingly through assessing mortality patients due to bowel obstruction and its associated factor.