PATTERN AND TREATMENT OUTCOME OF SMALL BOWEL OBSTRUCTION AMONG PATIENTS ADMITTED WITH ACUTE ABDOMEN TO SURGICAL WARD OF HIWOT FANA COMPREHENSIVE SPECIALIZED HOSPITAL, HARAR, ETHIOPIA: CROSSECTIONAL STUDY.

Abstract

Small bowel obstruction is a common potentially catastrophic surgical emergency in all age group in the world. Pattern and treatment outcome of Small bowel obstruction in eastern Ethiopia communities have not yet been thoroughly investigated. Objective: The aim of the study is to assess pattern and treatment outcome of small bowel obstruction among patients admitted with acute abdomen to surgical ward of HiwotFana Comprehensive Specialized Hospital surgical ward, harar, Ethiopia. Data was retrieved from September 1, 2020 – September 30, 2022. Method: The study was conducted among 192 cases using crossectional study design and following convenience sampling technique. Structured extraction format was used to collect relevant data. Data was interred to Epi info 7.2; analyzed using Statistical Package for the Social Sciences version 25 software package. Bi-variate and Multi-variate logistic regression was employed to assess association between dependent and independent variables with 95% CI and p-value less than 0.05. Result:A total of 192 files were used; with data retrieval rate of 88.48 %.Twenty two patients were managed non operatively and 170 patients were operated. The mean age was 34 + 14.3years and the male to female ratio was 9:1.Simple small bowel volvulus was the predominant intraoperative finding (40.8%) followed by gangrenous Small bowel obstruction (29.8%) of any causes then Adhesion or band (21.2%). Derotation was the common procedure done (50%). Favorable outcome was found in 66.7% of the cases. Surgical Site Infection (27.5%) was the most common complication. gangrenous Small Bowel Obstruction had 91.1% times more likely to have unfavorable outcome compared to those with simple Small Bowel Obstruction (AOR-0.089 CI=95% (0.009-0.850)P-0.036. Conclusion and Recommendation: common pattern was primary Small bowel volvulus. Comorbidity, Leukocytosis and having abdominal tenderness were associated with unfavorable outcome. Community awareness about bowel obstruction should increase to avoid late presentation.