3.9 Intestinal Obstruction

Question 1

8 causes of intestinal obstruction?

Answer 1

• meconium ileus
• Hirschsprung’s disease
• duodenal atresia
• intussusception
• malrotation with a volvulus
• strangulated hernia
• oesophageal atresia
• (pyloric stenosis)

Question 2

Presentation of intestinal obstruction?

Answer 2

• persistent vomiting, may be bilious
• high pitched tinkling bowel sounds, progress to absent
• no stool or wind passing
• abdo pain and distention

Question 3

Diagnosis / Ix of intestinal obstruction?

Answer 3

Abdo xray:

• dilated loops of bowel
• absence of air in rectum

Question 4

Management of intestinal obstruction?

Answer 4

• refer as paediatric surgical emergency
• nil by mouth
• NG tube to drain stomach and stop vomit
• IV fluids and electrolytes