Bowel obstruction

Question 1

Bowel obstruction

Answer 1

Blockage of the lumen of the intestine that impedes passage of gas and contents through the bowel

Question 2

Bowel obstruction causes/incidence

Answer 2

Adhesions
Hernia
Volvulus
Tumors
Fecal impaction
Ileus 

Question 3

Bowel obstruction signs/symptoms

Answer 3

Cramping periumbilical pain initially; later becomes constant and diffuse

Vomiting within minutes of pain proximal, within two hours of pain distal

Minimal or no fever

Question 4

Bowel obstruction physical findings

Answer 4

** hi pitched, tinkling bowel sounds
Minimal abdominal distention proximal
Pronounced abdominal distention distal
Mild tenderness but no peritoneal findings
Unable to pass stool/gas

Question 5

Bowel obstruction lab/diagnostics

Answer 5

Lab findings normal in initial stages
Later Macy elevated WBC’s in values consistent with dehydration
Plain films show dilated loops of the bowel and air fluid levels
Horizontal pattern in SBO
Frame pattern in LBO

Question 6

Bowel obstruction management

Answer 6

Fluid resuscitation
NG suction
Surgical intervention in all cases of complete obstruction
Impartial obstruction may treat medically