Bowel Obstruction

Question 1

What are the causes of bowel obstruction?

Answer 1

Adhesions
Hernias
Malignancy
Volvulus
Diverticular disease
Strictures
Intussusception

Question 2

What is the most common cause of small bowel obstruction?

Answer 2

Adhesions

Question 3

What is the most common cause of large bowel obstruction?

Answer 3

Malignancy

Question 4

What is a closed loop obstruction?

Answer 4

Two points of obstruction along the bowel causing an area sandwiched between the points

Question 5

What is the presentation of bowel obstruction?

Answer 5

Vomiting
Abdominal distention
Diffuse abdominal pain
Absolute constipation
Lack of flatulence
Tinkling bowel sounds

Question 6

What are the upper limits of the normal diameter of bowel?

Answer 6

3cm - small bowel
6cm - colon
9cm - caecum

Question 7

What is seen on abdominal XR in obstruction?

Answer 7

Distended loops of bowel

Question 8

What is the initial management of bowel obstruction?

Answer 8

Nil by mouth
IV fluids
NG tube with free drainage

Question 9

What is the initial investigation in bowel obstruction?

Answer 9

Abdominal XR
Erect CXR - air under the diaphragm in perforation

Question 10

What investigation is required for diagnosis of bowel obstruction?

Answer 10

Contrast abdominal CT

Question 11

What are the complications of bowel obstruction?

Answer 11

Hypovolaemic shock
Bowel ischaemia
Bowel perforation
Sepsis