Trends in Mechanical Intestinal Obstruction: A 30‑Year Comparative Analysis Between Developing and Developed Nations.

Background

Mechanical intestinal obstruction (MIO) remains a global surgical emergency with significant morbidity and mortality. While prior studies suggest divergent etiological patterns between developed and developing nations, recent trends and underlying drivers remain understudied.

Objectives

This study evaluates 30‑year trends in MIO etiology and outcomes in Jordan and compares these with global data to assess convergence of patterns.

Methods

A retrospective cohort study (2020-2023) of MIO patients at a tertiary Jordanian center was combined with a systematic literature review of MIO etiologies in developed and developing nations pre‑ and post‑2000. Data included demographics, management, outcomes, and mortality. Statistical analysis employed chi‑square and t‑tests. Findings: Postoperative adhesions were the leading cause of MIO (64% in 2023, rising from 25% in 1993), followed by malignancy (20%) and hernias (5%). Mortality was 10%, with sepsis as the primary cause. Global comparisons revealed adhesions as the predominant etiology in both developed (7/9 studies, 77.7%) and developing nations (8/14 studies, 57.1%) post‑2000, contrasting with historical hernia predominance in developing regions.

Conclusion

Adhesions have become the leading cause of MIO globally, reflecting increased surgical access and aging populations. Socioeconomic advancements in developing nations may explain converging trends with developed countries. Standardized global reporting and adhesion prevention strategies are urgently needed.