DOI: 10.36347/sasjs.2022.v08i07.002

Pages: 472-478

Introduction: Some major hospitals and clinics still insist on exploratory surgery when they evaluate a case of Intestinal obstruction in a patient with an otherwise virgin abdomen. Objective: The purpose of this research is to identify the causes of SBO in people who have never performed abdominal surgery. Materials and Methods: Multicentered based nonrandomized quasi experimental prospective study was performed in Northern International Medical College, Dhaka, Bangladesh from January 2018 to December 2021.Total number of patients n=60 treated for Intestinal obstruction due to bands in virgin abdomen. Follow up data, operative and pathologic findings were examined to determine the etiology of SBO. Results: Sixty patients met inclusion criteria; abdominal exploration was performed in 50 patients (83%) and 10 patients (17%) were managed non-operatively. Exploration was therapeutic in 29 (58%), negative in 20 (40%) and non-therapeutic in one patient (2%). Overall, 8 patients (13%) were diagnosed with a malignancy: right-sided colon cancer (n=3), small bowel (SB) neuroendocrine tumor (n=2), SB lymphoma (n=2) and carcinomatosis peritonei (n=1); six patients were diagnosed at the time of the initial exploration and two patients were diagnosed during follow up. Upon Prospective Study, both SB neuroendocrine tumors and one SB lymphoma were visible on the initial imaging. Leukocytosis (p=.03) and no recent weight loss (p=.04) were associated with negative exploration. Conclusion: Patients with a "virgin abdomen" generally have a non-threatening form of Intestinal obstruction in its earliest stages. Careful evaluation of imaging investigations is required for spotting early warning symptoms of a more serious illness. If the patient prefers non-surgical treatment, they will need to have a recent colonoscopy and give relevant examination findings history.