Bowel Obstruction Flashcards

1
Q

What are the 2 main subcategories of intestinal obstruction

A

Mechanical
Adynamic Ileus aka paralytic ileus

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2
Q

What is the difference between the mechanical and adynamic obstruction?

A

Mechanical: physical blockage of intestinal tract lumen
Adynamic: dysfunction of the intestinal tract

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3
Q

What are the 2 most common causes of small bowel obstruction in the US?

A

Adhesions (most common)
Hernias (second most common)

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4
Q

What surgery can cause adhesions that lead to small bowel obstruction

A

Intra-abdominal surgery

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5
Q

What is a hernia?

A

Incarceration and/or strangulation loops of small bowel

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6
Q

In less developed countries, what are the common causes of small bowel obstructions

A

Hernias (most common)
Adhesions (second most common)
Flipped due to lack of developed health care system

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7
Q

Less common causes of bowel movements

A

Intra-luminal polyps
Lymphoma
Adenocarcinoma

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8
Q

A patient with the urge to move and unable to find a comfortable position as if they are subconsciously trying to unobstructed their bowels likely has what condition?

A

Mechanical obstruction

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9
Q

Why would a patient with mechanical obstruction have intermittent pain?

A

Periotic contractions of peristalsis passing over obstructed portion of the bowel

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10
Q

What will the abdomen of a patient with mechanical obstruction be?

A

Distended

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11
Q

What characteristics will the vomit be of a patient with mechanical obstruction?

A

Bilious if obstruction is proximal
Feculent if distal ilium is proximal

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12
Q

Percussing the abdomen in a patient with mechanical obstruction will have what sound?

A

Tympany

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13
Q

A patient with paralytic ileus will have more of less pain than a mechanical obstruction?

A

Less pain but will be constant

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14
Q

What will the bowel sound of a patient with paralytic ileus be?

A

Diminished

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15
Q

What is the gold standard for dx small bowel obstruction?

A

Upright abdominal x ray

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16
Q

When would surgery be needed in a patient with small bowel obstruction?

A

Gangrene or necrosis is suspected (WBC>20,000)
Failure of conservative therapy

17
Q

What is the disposition of patients with small bowel obstruction?

A

MEDEVAC for mechanical obstruction
MEDADVICE minimum for paralytic ileus
Gen Surg consult

18
Q

What causes almost all large bowel obstructions?

A

Caused intrinsically with the majority being from adenocarcinoma

19
Q

Why are large bowel obstructions not normally caused from hernias or adhesions?

A

Ascending and descending colon are embedded within the retroperitoneum

20
Q

What kind of vomitus might a patient with large bowel obstruction have?

A

Feculent vomitus