To evaluate surgical treatment results in patients with intestinal obstruction

Relevance. Acute intestinal obstruction (AIO) remains the focus of clinicians’ attention. The mortality rate in this pathology is 5.1–8.4 %, occupying one of the leading places among all urgent diseases. The diagnosis and treatment of patients with intestinal obstruction remain relevant.
Objective. Assessment of AIO treatment results based on an improved set of therapeutic measures.
Materials and methods. This study enrolled 1279 patients aged 20–90 years with various AIO course variants. The dynamics of water and electrolyte metabolism, endogenous intoxication, and treatment outcomes in different age groups were studied depending on the etiology, stage of intestinal obstruction, and volume of surgical intervention.
Results. Studies have shown increasing changes in water and electrolyte metabolism during the stage of enteral hypertension, with the most significant changes in the development of peritonitis and multiple organ failure. The progressive accumulation of toxic metabolic intermediates, noted at the very beginning of the disease, also depended on the intestinal obstruction stage. The episode of adhesive intestinal obstruction was conservatively resolved in 68 % of patients. The average mortality rate among all patients was 8.7 %. Intestinal resection was required in 20.1 % of patients, which increased the mortality rate to 23.2 %. The incidence of death in cases of tumor obstruction was 3.8 times higher than that in patients with non-tumor genesis of the disease. The addition of multiple organ failure was accompanied by an increase in mortality by more than 10 times.
Conclusions. In AIO, age >75 years, the need for intestinal resection, and the development of multiple organ failure syndrome are prognostic risk factors for an adverse outcome, regardless of hospitalization duration.

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