Bowel Obstruction Flashcards
Pathognomic symptom of bowel obstruction
Absolute constipation (neither faeces or flatus are passed)
What is a closed loop obstruction?
The ileo-caecal valve remains competent and you have an obstruction. (I.e you have no back flow and the bowel just becomes distended etc)
What causes hypertrophy of the muscle in the bowel wall? What does peristalsis feel like in this hypertrophic muscle?
Incomplete obstruction
Colicky pain
Abdominal tenderness in intestinal obstruction?
There is a relative lack of tenderness in intestinal obstruction. Obstruction with tenderness may indicate bowel strangulation
Percussion of abdomen in obstruction?
Percussion tends to be resonant due to gaseous distension
Acute presentation within hours and large volume of vomit is suggestive of which kind of obstruction?
Upper small bowel obstruction
Colicky pain and (possibly faeculant) vomitting are suggestive of what?
Distal small bowel/large bowel obstruction
What is the most useful investigation in suspected bowel obstruction?
AXR (Use a CT to find the transition point)
How can adhesions form?
Previous surgery or peritonitis
What kind of tumours could cause bowel obstruction?
Gastric cancer blocking the pylorus, small bowel tumours (rare), large bowel cancer
Inflammatory strictures can be caused by what?
Crohn’s disease
Divericular disease
What is usually initiated by a mass in the bowel wall i.e. enlargement of lymphatic tissue or tumour
Intussusception
commoner in children
What does pain over a hernia suggest?
Strangulation
Requires urgent surgical intervention
Paralytic ileus and pseudo obstruction are examples of what?
Adynamic obstruction
