Figure 1
PRISMA 2020 flow diagram for the systematic review of MIO etiology (pre‑and post‑2000).
Table 1
Baseline characteristics and clinical outcomes of patients with mechanical intestinal obstruction (n = 177).
| VARIABLE | VALUE |
|---|---|
| Mean age (years) | 54.4 ± 19 (Range: 13–81) |
| Gender | Male: 97 (55%) Female: 80 (45%) |
| Presenting symptoms | Vomiting: 139 (79%) Abdominal pain: 136 (77%) Constipation: 98 (56%) Nausea: 46 (26%) |
| Comorbidities | Hypertension: 67 (39%) Diabetes: 45 (26%) Malignancy: 43 (25%) Heart failure: 13 (7%) IBD: 9 (5%) |
| Previous abdominal/pelvic surgery | 142 (81%) |
| Mean duration of symptoms (days) | 6.5 ± 4.7 (Range: 1–60) |
| Mean hospital stay (days) | 5.6 ± 3.5 (Range: 1–30) |
| ICU admissions | 15 (8%) |
| SAPS III scorea (ICU patients) | Mean: 62 (Range: 42–76) |
| ICU mortality | 6/15 (40%) |
| Overall mortality (all patients) | 18 (10%) |
| Causes of death | Sepsis: 17 (94%) Aspiration pneumonia: 1 (6%) |
| Outcomes (within 3 months) | Full recovery: 119 (68%) Recurrence: 30 (17%) Death: 18 (10%) Complications (incl. re‑op): 7 (4%) |
[i] a: SAPS: Simplified acute physiologic score, for patients admitted to ICU.
Table 2a
Etiology of mechanical intestinal obstruction (n = 177).
| ETIOLOGY | NO. OF PATIENTS (%) |
|---|---|
| Adhesions | 112 (64%) |
| Malignancy | 36 (20%) |
| Hernia | 9 (5%) |
| Inflammatory bowel disease (IBD) | 7 (3%) |
| Sigmoid volvulus | 3 (1.5%) |
| Diverticular disease | 2 (1%) |
| Intussusception | 2 (1%) |
| Malrotation | 2 (1%) |
Table 2b
Management modalities and surgical procedures.
| MANAGEMENT APPROACH/SURGICAL PROCEDURE | NO. OF PATIENTS/CASES |
|---|---|
| Conservative treatment | 113 (64%) |
| Surgical intervention | 62 (36%) |
| Adhesiolysis | 23 (37%) |
| Colectomy | 16 (26%) |
| Small bowel resection | 4 (6%) |
| Colostomy | 4 (6%) |
| Sigmoidectomy (Hartmann’s) | 3 (5%) |
| Ileostomy | 1 (1.6%) |
| Ladd’s procedure | 2 (3%) |
| Hernia repair | 2 (3%) |
| Meckel diverticulectomy | 1 (1.6%) |
| Gastrojejunostomy | 1 (1.6%) |
Figure 2
Percentage of the main causes of MIO in North Jordan (1993, 2012, and 2023).
Table 3
Global comparison of MIO etiology and mortality by region and time period.
| STUDY (YEAR) | COUNTRY | PERIOD | ECONOMIC STATUS | MOST COMMON CAUSE | MORTALITY RATE |
|---|---|---|---|---|---|
| Ti et al. (1976) [11] | Malaysia | 5 yrs pre‑2000 | Developing | Adhesions | 9–13% |
| Pal et al. (1982) [12] | India | 5 yrs pre‑2000 | Developing | Ventral hernias | 28% |
| Steityeh et al. (1993) [4] | Jordan | pre‑2000 | Developing | Ventral hernias | NA |
| Hasnain et al. (1994) [2] | Pakistan | 1987–1991 | Developing | Adhesions 43% | NA |
| Mohamed et al. (1997) [13] | Saudi Arabia | 10 yrs pre‑2000 | Developing | Adhesions 45%, then hernia | 3.5% |
| Ntakiyiruta & Mukarugwiro (2009) [14] | Rwanda | 2003–2007 | Developing | Ventral hernias | NA |
| Obaid (2011) [15] | Malaysia | 2003–2007 | Developing | Ventral hernias | 4.3% |
| Kapan et al. (2012) [16] | Turkey | 2005–2010 | Developing | Adhesions | NA |
| Jiang et al. (2019) [17] | China | 2004–2013 | Developing | Adhesions | NA |
| Yusuf et al. (2014) [18] | Pakistan | 2012–2013 | Developing | Strictures | NA |
| Jena et al. (2021) [19] | India | 1996–2019 | Developing | Adhesions ↑ from 23% to 51.6% | NA |
| Fekadu et al. (2022) [20] | Ethiopia | 2022 | Developing | Small bowel volvulus | NA |
| Idrobo et al. (2020) [21] | Colombia | 2012–2013 | Developing | Adhesions | 1% |
| Wasim Yusuf et al. (2014) [18] | Pakistan | 2012 | Developing | Obstruction/perforation (histopathology) | NA |
| Tondelli et al. (1983) [22] | Switzerland | 5 yrs pre‑2000 | Developed | Adhesions | 14% |
| Cross & Johnston (1987) [23] | Ireland | 1947–1982 | Developed | Ventral hernia | NA |
| da Silva et al. (1994) [24] | Portugal | 1981–1991 | Developed | Hernia 44%, then adhesions 15% | 10.8% |
| Miller et al. (2000) [25] | Canada | 1986–1996 | Developed | Adhesions (then Crohn’s) | NA |
| Markogiannakis et al. (2007) [26] | Greece | 2001–2002 | Developed | Adhesions | 0.8% |
| Stephenson & Singh (2011) [27] | UK | 2011 | Developed | Adhesions | 10–25% |
| Trivedi et al. (2012) [28] | USA | 2005–2011 | Developed | Adhesions | NA |
| Beardsley et al. (2014) [29] | Australia | 2009–2013 | Developed | Adhesions | NA |
| Paul et al. (2022) [30] | Germany | 2009–2019 | Developed | Adhesions | 4.9–15.9% |