Etiological Spectrum of Intestinal Obstruction in Adults Having Virgin Abdomen

Background: Intestinal obstruction is a common surgical emergency with significant morbidity and mortality, but postoperative adhesions are its most frequent cause. Patients with a virgin abdomen—those without any prior abdominal surgery—pose diagnostic challenges; this study explored the etiological spectrum, clinical features, and outcomes of such cases in a tertiary care hospital in Pakistan. Methods: A six-month prospective observational study at Lady Reading Hospital, Peshawar, enrolled 73 eligible adult patients, categorizing them into Group 1 (surgical management for mechanical causes such as hernias, tumors, or volvulus) and Group 2 (conservative management for functional or self-resolving causes). Data collected encompassed demographics, presenting symptoms, vital signs, symptom duration, and etiological factors, supplemented by relevant laboratory investigations and imaging studies. Statistical analysis was performed using SPSS version 26, with continuous variables summarized as mean ± standard deviation and compared using the independent t-test, categorical variables presented as frequencies and percentages and analyzed using the Chi-square or Fisher’s exact test, and a p-value of <0.05 considered statistically significant. Results: The mean age of Group 1 was significantly higher (55.73 ± 4.86 years) than Group 2 (44.13 ± 6.32 years, p < 0.001). Tumors were the most common cause (24.7%), followed by hernias (20.5%) and volvulus (13.7%). Group 1 had longer hospital stays (12.45 ± 2.94 days vs. 7.76 ± 2.03 days, p < 0.001) and higher clinical severity. Complications and mortality rates were low and comparable between groups, with effective management in both cohorts. Conclusion: The cause of intestinal obstruction differs in patients with a virgin abdomen of which has a vast clinical impact. It demands early diagnosis and proper treatment plans to enhance the quality of life and reduce mortality. Further investigations of patient follow-up with focus on discharge and ways of minimizing the number of days patients spend in the hospital are important.