dc.contributor.author | Ligeyo, EO | |
dc.date.accessioned | 2013-05-23T14:28:15Z | |
dc.date.available | 2013-05-23T14:28:15Z | |
dc.date.issued | 2006 | |
dc.identifier.citation | M.Med (Surgery) Thesis | en |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/25014 | |
dc.description | Master of Medicine Thesis | en |
dc.description.abstract | SUMMARY
The choice between initial surgical or non-operative management of mechanical bowel
obstruction still remains a challenge. This was a prospective study carried out over a period
of ten months from 1st September 2005 to 30th June 2006. The broad objective was to
evaluate the pattern and treatment of patients with mechan ical intestinal obstruction at
Kenyatta National Hospital.
Methodology: Data on demographic characteristics, management, and outcome were
collected using questionnaires. The main outcome measures were duration of hospital stay,
the need of operative treatment, and the incidence of bowel strangulation, complications and
death. This data was analyzed and presented in tables, charts and graphs.
Results: A total of 120 patients with intestinal obstruction were recruited into the study.
The ages ranged from 13 to 84 years with a mean of 38 years. The male to female ratio was
2:l.Thirty six percent of the patients [43] had previous laparotomies. The small-gut was
involved in 65% of the cases while the large gut was involved in 35% of the cases. The
underlying lesions were: adhesions and bands [44%], volvulus [20%], faecal impaction
[17%], tumours [8%], helminthiasis [4%], hernia [4%] and intussusception [3%]. Fifty two
percent of the patients were managed conservatively, 29% were managed by early operation
and 19% were managed by late operation. The main indications for early operative
management were signs of peritonitis [49%], intractable pain [20%], leukocytosis [17%], and
hernia [14%]. The indications for late operation were failure of resolution [49%], peritonitis
[38%], and worsening of the general condition [13%]. Intra-operatively the definitive
surgical procedures included; resection and primary anastomosis [49%], adhesiolysis [22%],
resection and colostomy [18%], derotation and decompression [11%]. The resection rate in
the early operation group due to non-viable strangulation was 22/35 [63%] and 15/20 [75% | en |
dc.description.sponsorship | University of Nairobi | en |
dc.language.iso | en | en |
dc.title | Evaluation of treatment of patients with mechanical intestinal obstruction at Kenyatta National Hospital | en |
dc.type | Thesis | en |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |
local.publisher | Department of Medicine, University of Nairobi | en |