Bowel Obstruction Flashcards
Where can bowel obstruction be?
SI or LI
What is partial bowel obstruction?
some contents can pass (Sx less severe)
What is complete bowel obstruction?
total obstruction Sx progress rapidly
What is simple strangulated bowel obstruction?
compromised blood supply leads to ischaemia and gangrene (6hr)
What are causes?
- Bowel obstruction
- Stasis of luminal contents and gas proximal to the obstruction
- Increased intraluminal pressure
- Abdonimal distention and dehydration and hypovolaemia and vomiting
- Compression of vessels can cause ischaemic and gangrene
What are main causes for SI and LI obstruction?
SI: surgery (adhesions)
LI: malignancy (90%)
Which type of obstruction is more common?
SI more common (80%)
What are symptoms and signs of bowel obstruction?
- Severe colicky pain
- Abdo distention
- Vomiting (bilious)
- Constipation/obstipation
- Tinkling bowel sounds
What imaging is done for obstruction?
supine AXR
What does AXR show for SI obstruction?
- 3-5cm dilation
2. Vulvulae Convientae (all the way across)
What does AXR show for LI obstruction?
- > 5cm dilation
2, Haustra (don’t go all the way)
What other investigations are done for bowel obstruction?
- High WBC if strangulation/gangrene
2. U+Es if signs of dehydration
What is conservative management for bowel obstruction?
- NBM + NG tube (decompress bowel)
- IV fluids
- urinary catheter
- analgesia
What is management for acute obstruction / strangulation / ischaemic bowel signs?
laparotomy
What is management if SI is secondary to adhesion?
conservative Mx – contrast enema within 24 hours to check
