Acute mechanical bowel obstruction: A comprehensive analysis of clinical presentation, etiology, surgical management, and postoperative outcomes in a yemeni cohort

Purpose: This study aims to investigate the clinical presentation, etiology, and management outcomes of acute mechanical bowel obstruction (AMBO) in Yemen, focusing on predictors of postoperative complications and mortality. Patients and Methods: A prospective observational study was conducted at Al-Thawra Modern General Hospital in Sana’a, Yemen, from October 2022 to October 2023. We enrolled 106 patients with AMBO, collecting data on demographics, clinical presentation, management strategies, surgical interventions, complications, and outcomes. Logistic regression identified risk factors for postoperative complications and mortality. Results: The study population consisted predominantly of males (66%) aged 31–60 (51%). Common symptoms included vomiting (96.2%), constipation (90.6%), and abdominal distention (83.0%). Adhesions (41.5%) were the most frequent cause, followed by hernias and large bowel masses (22.6% each). Surgical intervention was necessary in 71.7% of cases, with resection and anastomosis as the most common procedure (29.2%). Postoperative complications occurred in 36.8% of surgical patients, with wound infections being the most prevalent (31.6%). Significant predictors of complications included resection and anastomosis (OR = 19.541, 95% CI: 3.655–104.466, p = 0.001) and delayed presentation (7–10 days) (OR = 11.433, 95% CI: 1.230–106.252, p = 0.032). Mortality was associated with ICU admission (OR = 1.719, 95% CI: 1.019–2.904, p = 0.029), sepsis (OR = 2.771, 95% CI: 1.451–5.292, p < 0.001), and hypothermia (OR = 1.451, 95% CI: 1.019–2.071, p = 0.042). Conclusion: AMBO predominantly affects middle-aged males in Yemen, with adhesions being the leading cause. Surgical intervention, while often necessary, carries significant risks, particularly with delayed presentation. Early diagnosis and timely intervention are crucial to improving patient outcomes. Further studies are needed to validate these findings and develop optimized treatment protocols.