International Journal of Health and Clinical Research
Yazarlar: Shobhik Chakraborty, Kaushik Kar, Debabrata Ray, Debangshu Bhanja Choudhury
Konular:-
Anahtar Kelimeler:Intestinal obstruction,SGOT,CPK,LDH.
Özet: Introduction: Intestinal obstruction is a common surgical emergency that accounts for at least 20% of all admissions to a surgical service (1). It is any impedance to normal flow of bowel contents and can be classified largely as dynamic (mechanical) or a dynamic (functional) obstruction.(2,3) Dynamic obstruction is a mechanical problem caused by a physical blockage which can either be extra luminal (extrinsic), mural (intrinsic) or intraluminal. Materials and Methods: The Inpatient Department of the Department of General Surgery, Calcutta National Medical College and Hospital, 24 Gorachand Road, Kolkata-700014. Patients admitted under the Department of General Surgery in Calcutta National Medical College and Hospital, Kolkata, diagnosed as acute mechanical intestinal obstruction clinically, radiologically by Straight X-Ray abdomen and intra operatively by direct inspection on exploration of abdomen. Results: Out of 77 male patients with acute mechanical small bowel obstruction, 22 patients had gangrene (28.571%). Of the 23 female patients in our study 5 patients had gangrene (21.739%). The mean value of serum amylase, serum LDH, serum CPK, serum SGOT were found statistically significantly increased in patients with gangrenous gut in comparison to patients with normal gut. Crosstab analysis was also done for serum marker level taking highest normal value range in patients with evidence of gangrene of gut and in patient with non-gangrenous gut. These data was also found statistically significant. Conclusion: Acute intestinal obstruction is an important surgical emergency with significant morbidity and mortality. From this study it is evident that increased pre operative serum Amylase, SGOT, CPK, LDH strongly indicates an underlying gangrenous change. These tests are less invasive, cost effective and easily available diagnostic tool to diagnose bowel ischemia/gangrene. Hence these are more useful in centres where the diagnostic facilities are limited.