Bowel Obstruction Flashcards

1
Q

Why does bowel obstruction cause vomiting and dilatation of intestines?

A

Build up of gas causing back-pressure

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2
Q

How does bowel obstruction lead to hypovolaemia and shock?

A

GI tract secretes fluid that is absorbed in the colon

Obstruction prevents fluid from being reabsorbed

Fluid loss from the intravascular space into GI tract

Third-spacing

Higher up the obstruction the greater the fluid loss

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3
Q

What 3 causes make up 90% of cases of bowel obstruction?

A

Adhesions (small bowel)
Hernias (small bowel)
Malignancy (large bowel)

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4
Q

What other causes can cause bowel obstruction?

A

Volvulus
Diverticular disease
Strictures
Intussusception

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5
Q

What are adhesions?

A

Scar tissue that bind abdominal contents together

Typically cause obstruction in the small bowel

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6
Q

What are the main causes of intestinal adhesions?

A

Abdominal or pelvic surgery
Peritonitis
Abdominal or pelvic infections
Endometriosis

May be congenital or due to radiotherapy

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7
Q

What is a closed-loop obstruction?

A

Two points of obstruction along the bowel
May happen with:
- Adhesions
- Hernias
- Volvulus
- Single point obstruction with competent ileocecal valve

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8
Q

Why is a closed-loop obstruction an emergency?

A

No end in which they may drain and decompress

Continuous expansion leading to ischaemia and perforation

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9
Q

What are the key features of bowel obstruction?

A

Green bilious vomiting
Abdominal distention
Diffuse abdominal pain
Absolute constipation and lack of flatulence
Tinkling bowel sounds

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10
Q

What is the initial management of bowel obstruction?

A

Nil by mouth
IV fluids
NG tube with free drainage
Catheterise
Group and Save

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11
Q

What imaging is used in bowel obstruction?

A

Abdominal x-ray

Erect CXR- looking for air under the diaphragm

Contrast Abdominal CT- can also diagnose any intra-abdominal perforation

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12
Q

What surgical intervention is available for bowel obstruction?

A

Exploratory surgery
Adhesiolysis
Hernia repair
Emergency resection
Stents

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