3-Intestinal Obstruction Flashcards

1
Q

Why cant the intralumenal tumor cant pass to the extralumenal area?

A

Bcz the colon still has living cells, unless it is ischemic and the cells die

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2
Q

Strangulated obstructions

A

Disruption of the blood circulation

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3
Q

Closed loop obstruction

A

Volvulus

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4
Q

simple obstruction

A

Presence of obstacle in the transmission of the contents of the intestine *without a problem in blood circulation

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5
Q

Which one is not an extraluminal mechanical obstruction ?

A
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6
Q

What are examples of extraluminal mechanical obstruction?

A

Adhesion
Hernia
Neoplastic tm
Small bowel and colon volvulus
Superior mesenteric artery syndrome

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7
Q

Hernia?

A

Defect in the fascia allow for the intestines to pass

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8
Q

What is superior mesenteric artery syndrome

A

Duodenum gets squeezed by two arteries

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9
Q

How does tubular organs heal?

A

With contractions

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10
Q

What are the transmural(between wall) mechanical obstruction examples

A

[CO.S.T.I.]

congenital(stenosis, Meckel’s diverticulum)

traumatic

inflammatory

strictures(restriction)

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11
Q

What are the intraluminal mechanical obstruction examples?

A

Meconium ileus
Invagination
Gallstone ileus (rare)
Feces
Bezoar
Flocculated parasites

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12
Q

What is the most imp physical exam for mechanical obstruction?

A

Mainly Ask about if they fart not if they poop(it may be diarrhea):p

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13
Q

during Early period ‘stage’ bowel obstruction, what do you hear on auscultation

A

Metalic sounds

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14
Q

Late period bowel sounds

A

No sounds

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15
Q

***Which is the electrolyte that is most lost during vomiting?

A

HCl
And later loss of potassium bcz the kidney holds on the H+ and secretes away potassium; hypochloremia+ hypokalemia+ metabolic alkalosis

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16
Q

Colonic obstruction causes perforation in the ……

A

Cecum

17
Q

Proximal dilation of colon

A

Causes distention

18
Q

Ileocecal part u wont see any

A

Diarrhea…?

19
Q

When do u see coffee bean sign under radiograph?

A

In volvulus

20
Q

Treatment for colonic obstruction

A

-For dehydration: isotonic or ringer lactate iv
-After checking for urine output,Potassium must be given
-Nasogastric tube insertion
-Broad spectrum antibiotics

21
Q

In which type of intestinal obstruction do u see ischemia

A

In strangulated obstruction of the colon

22
Q

Unless it is adhesion obstruction, you always need ….. as treatment

A

Emergent surgery such as in :S.C.C.S
-strangulated obstruction
-closed loop obstruction
-colonic obstruction
-simple mechanical obstruction

23
Q

Does adhesions of the intestines reoccur

A

Yes it may occur again,

24
Q

No colic style abdominal pain and bowel sounds are reduced in which are of the GIS obstruction?

A

Ileus obstruction

25
Q

Hypothyroidism, spinal cord injury,electrolyte disorders,pancreatitis,Surgical stress, retroperitoneal hematoma, may be a cause of obstruction in …..

A

Ileus

26
Q

Which one is revesible obstruction

A

Ileus

27
Q

Which one is irrevesible obstruction

A

Intestinal psodoobstruction

28
Q

when do you hear metallic sounds on auscultation

A

during early stage of bowel obstruction

29
Q

when does dehydration due to vomiting, hypochloremia, hypokalemia, and metabolic alkalosis are seen?

A

proximal obstruction

30
Q

symptoms of intestinal obstruction

A

abdominal pain colic style

nausea vomiting

distension

gas-fecal inability to pass

31
Q

what is the tx for adhesion?

A

NG tube conservative tx can be extended up to 24-48 hrs

32
Q

what is the benefit of NG tube?

A

reduce risk of aspiration

reduces tension(to improve blood circulation)

in obstruction due to adhesion

33
Q

what are the non mechanical intestinal obstruction reasons?

A

ileus
pseudo obstruction

34
Q

is ileus treatable?

A

yes; by giving NG if vomiting or distension
and fluid-electrolyte therapy and TPN

35
Q

which type of intestinal pseudoobstruction occurs in intestinal smooth muscle, myenteric plexus, extraintestinal nervous system?

A

intestinal pseudo-obstruction

36
Q

definitive dx of intestinal pseudo-obstruction?

A

laparotomy and full thickness biopsy of intestine

37
Q

which layer of the intestine is affected in the intestinal pseudo-obstruction

A

muscularis propria; myenteric and miessner plexus

38
Q
A