Abstrait

A study on the pathology of acute intestinal obstruction in Upper Egypt.

Dalia Badary, Howyda Hassan, Abdel Hady Omar, Ahmed Ashmawy

Acute intestinal obstruction remains a major clinical presentation of Egyptian patients in Upper Egypt. The current study was conducted to speculate on cases of acute intestinal obstruction from a clinico-histopathological point of view. The study was retrospective, included 186 patients presented with acute intestinal obstruction during the period from January 2009 to December 2017. Male patients were a bit more commonly affected than females. It is apparent from this study that acute on top of chronic intestinal obstruction is still a major problem. The research was aiming at finding the most common histopathological findings in representative cases of acute intestinal obstruction. Adenocarcinoma of the intestine took the priority of cases in the represented biopsies (27%), followed by reactive hyperplasia of mesenteric lymph nodes (10%), non- Hodgkin's lymphoma (7%) and mesenteric vascular occlusion (5%). We observed that patients with biopsy diagnosis as adenocarcinoma and non-Hodgkin's lymphoma had been complaining of symptoms of chronic intestinal obstruction over many years before the development of acute obstruction. So, from this point, the doctors in all specialties (gastroenterology, surgery, and histopathology) must consider cases of chronic intestinal obstruction seriously, as these lesions often predispose to acute intestinal obstruction. They should always keep on eye to guard against any complication including acute intestinal obstruction. From this study, we could determine many pathological effects of acute intestinal obstruction such as hemorrhagic infarction, gangrene of the intestine and peritonitis. These effects represented in our study about (12%) of the studied cases, half of these cases presented by hemorrhagic infarction of intestine. For affected patients, high-quality surgical expertise coupled with sound clinical judgment and early surgery when needed, confirmed with the histopathological diagnosis will greatly prevent complications and improve survival. Furthermore, a general improvement in healthcare infrastructure, especially in the rural communities, could further reduce mortality as patients may then present early.