Acute Intestinal Obstruction: Epidemiological Profile and Management from Two Years of Surgical Pratice in the Central Hospital of the Army of Algiers

Document Type : Research/Original Article


1 Department of Medicine, Central Hospital of the Army Docteur Mohamed Seghir Nekkache, Benyoucef Benkhedda, Kouba, Algiers University

2 Department of Medicine,Benyoucef Benkhedda, Kouba, Algiers University


Acute intestinal obstruction (AIO) is a frequent and serious medical and surgical emergency. In developing countries, the aetiologies of AIO are dominated by hernia strangulation, whereas in developed countries, the main cause of obstruction is postoperative flange, which accounts for 40% of cases. The aim of the study are represented by the determination of the epidemiological profile of AIO in our institution. We were also interested in the morbi-mortality of this pathological entity and in the evaluation of the management.
Material and methods:
The inclusion criteria were all patients aged over 18 years with mechanical AIO operated in our institution during two years.
The mean age of our patients is 61 years, with a sex-ratio of 1,4. There was 67% small bowel obstruction, and 33% colonic obstruction. The aetiology of small AIO is dominated by bridles in 53%, and that of a colonic cause by cancer in 72%. The computed tomography was used in 84,81% of cases. The mortality rate is 7,6% in all the series.
Our results are similar to other series but the cancerous aetiology of AIO is twice as frequent as in the literature. In our series, especially in cases of bowel obstruction, we have noted a high rate of intestinal resection of around 70%, compared to 41% in an African study.
These results should call on the public authorities in our country to develop screening for colorectal cancers in populations at risk, in order to manage them in time.


  1.  Macutkiewicz C, Carlson GL. Acute abdomen: intestinal obstruction. Surgery (Oxford). 2005 Jun 1;23(6):208–12.
  2. Ray NF, Denton WG, Thamer M, Henderson SC, Perry S. Abdominal adhesiolysis: inpatient care and expenditures in the United States in 1994. J Am Coll Surg. 1998 Jan;186(1):1–9.
  3. Behman R, Nathens AB, Mason S, Byrne JP, Hong NL, Pechlivanoglou P, et al. Association of Surgical Intervention for Adhesive SmallBowel Obstruction With the Risk of Recurrence. JAMA Surg. 2019 May 1;154(5):413–20.
  4. Thornblade LW, Verdial FC, Bartek MA, Flum DR, Davidson GH. The Safety of Expectant Management for Adhesive Small Bowel Obstruction: A Systematic Review. J Gastrointest Surg. 2019 Apr;23(4):846–59.
  5. Griffiths S, Glancy D. Intestinal obstruction. Surgery (Oxford). 2017 Feb 1;35.
  6. Bevan PG. Acute intestinal obstruction in the adult. Br J Hosp Med. 1982 Sep;28(3):258, 260–5.
  7. Sidibe M. Aspects épidémiologique, clinique et prise en charge des occlusions intestinales aiguës mécaniques dans le service de chirurgie générale et pédiatrique du CHU GABRIEL Touré (MALI).[Bamako].
  8. Roscher R, Frank R, Baumann A, Beger HG. [Results of surgical treatment of mechanical ileus of the small intestine. Chirurg. 1991 Aug 1;62(8):614–9.
  9. Sourkati EO, Fahal AH, Suliman SH, el RS, Arabi YE. Intestinal obstruction in Khartoum. East Afr Med J. 1996 May 1;73(5):316–9.
  10. Harouna Y, Yaya H, Abarchi H, Malala JR, Gazi M, Seibou A, et al. LES OCCLUSIONS INTESTINALES : Principales causes et morbi-mortalité à l’hôpital national de Niamey - Niger Etude prospective à propos de 124 cas.
    Médecine d’Afrique Noire. 2000;4.
  11. Sharma SK, Milsom JW. The evolution of surgery for the treatment of malignant large bowel obstruction. Techniques in Gastrointestinal Endoscopy. 2014 Jul 1;16(3):112–8.
  12. Sharma L, Srivastava H, Pipal DK, Kothari S, Dhawan R, Purohit PM. Acute intestinal obstruction: small intestine vs. large intestine: an analysis. International Surgery Journal. 2017 Dec 26;5(1):162–7.
  13. Cosse C, Sabbagh C, Carroni V, Galmiche A, Rebibo L, Regimbeau J. Impact of a procalcitonin-based algorithm on the management of adhesion-related small bowel obstruction. Journal of visceral surgery. 2017.
  14. Ye PJ. Analysis of the clinical symptoms of patients complicated with acute intestinal obstruction after the surgery of colon cancer. Journal of Acute Disease. 2016 Sep 1;5(5):430–3.
  15. Soressa U, Mamo A, Hiko D, Fentahun N. Prevalence, causes and management outcome of intestinal obstruction in Adama Hospital, Ethiopia. BMC Surg. 2016 Jun 1;16(1):38.
  16. Demessence R, Lyoubi Y, Feuerstoss F, Hamy A, Aubé C, Paisant A, et al. Surgical management of adhesive small bowel obstruction: Is it still mandatory to wait? - An update. Journal of visceral surgery. 2022.
  17. McFadden NR, Brown SK, Howard SM, Utter GH. Validity of the American Association for the Surgery of Trauma Intestinal Obstruction Grading System. Surgery in Practice and Science. 2022 Jun 1;9:100086.
  18. Barmparas G, Branco BC, Schnüriger B, Lam L, Inaba K, Demetriades D. The incidence and risk factors of  postlaparotomy adhesive small bowel obstruction. J Gastrointest Surg. 2010 Oct;14(10):1619–28.
  19. Gamal EM, Metzger P, Szabó G, Bráth E, Petõ K, Oláh A, et al. The influence of intraoperative complications on adhesion formation during laparoscopic and conventional cholecystectomy in an animal model. Surg Endosc. 2001 Aug;15(8):873–7.
  20. Lueders A, Ong G, Davis P, Weyerbacher J, Saxe J. Colonic stenting-A review of current indications and outcomes. The American Journal of Surgery. 2022 Jan 3.