03.06 Obstruction in Adults Flashcards
Most common site for unqualified intestinal obstruction
Small bowel
Second most common site for unqualified intestinal obstruction
Left side of the colon
Most common cause of obstruction
Post-operative adhesions
Second most common cause of obstruction
Hernia
Most common cause of intraluminal obstruction
Tumor
Intraluminal obstruction may also be caused by constrictions
Part of the stomach sliding up to the esophageal hiatus due to intra-abdominal pressure and a negative thoracic pressure
Hiatal hernia
Caused by a defect in the mesentery segments of the bowel, insinuating itself into the different false internal areas
Volvulus
Fecal material may be lodged in the weakened colonic wall causing _____
Diverticulitis
Congenital problem
Failure of de-rotation, the stomach and duodenum pulls the cecum through adhesive band, preventing it from going to the proper place and causing obstruction
Malrotation
Single bubble sign in chest x-ray
Hypertrophied pyloric ring
Segment of the bowel telescopes into another segment
Intussusception
Clinical condition of GIT where normal transmission is impeded so that products of digestion are prevented from exiting.
Urgent management is needed
Intestinal obstruction
Adhesion is proximal to the ligament of Treitz, there is ____
No abdominal distention
If the IO is distal to the D2 segment of the duodenum, there is ____ vomitus
Bilious
If the IO is proximal to the D2 segment of the duodenum, it is _____
Nonbilious
Most common conditions of mechanical IO
Adhesions
Malignancy
Hernia
Etiologies can range from derangement of sympathetic and parasympathetic control of the GIT, surgical trauma, and electrolyte imbalance
Functional IO
Distention of colon due to obstruction usually caused by defect in sympathetic nerve supply
Ogilvie’s syndrome
What type of loop obstructions are surgical emergencies
Closed loop
Distal tumor blocking and a competent ileocecal valve
Closed loop
Proximal bowel dilatation alters the:
GI motility
Mucosal lining
Absorptive capacity of the intestines
Distention proximal to obstruction is produced by
Gas
Fluid
Most important reference in terms of level of obstruction
Ligament of Treitz
Melena is black, sticky stool associated with bleeding in ____
Bezoar
Hyponatremia and hypochloremia
Proximal upper gut
Succus entericus
Fecaloid if obstruction is distal
Tenderness due to marked distention
Hypokalemia and hyponatremia
Distal lower gut
Dx of IO
Air fluid levels
Ileus
Endoscopy (intraluminal obstruction)
Associated conditions of IO
Dehydration, electrolyte, malnutrition and sepsis
Sequelae of IO
Necrosis
Rupture/perforation
Peritonitis
Sepsis
