Bowel Obstruction

Question 0

Causes of large bowel obstruction

Answer 0

• Faecal impaction
• Colorectal carcinoma
• Colonic volvulus
• Strictures –> Diverticular disease

Question 1

Causes for small bowel obstruction

Answer 1

• Adhesions
• Hernias
  “Bande en breuke”
• Neoplasms
• Strictures –> Chron’s, TB

Question 2

Signs and Symptoms

Answer 2

• Colicky pain
• Abdominal distention
• Vomiting
• Dehydration
• Constipation/Obstipation

Question 3

Ddx for bowel obstruction

Answer 3

• Gastroenteritis
• Diverticulitis
• Appendicitis
• Pancreatitis
• Intussusception
• IBD

Question 5

Management

Answer 5

1. IV fluids/nasogastric suction (incomplete obstruction)
2. Manual evacuation of faecal impaction
3. Endoscopic decompression of sigmoid volvulus
4. Surgery (closed loop/strangulated obstruction)

Question 6

Special Investigations

Answer 6

• U&E + blood gasses
• AXR (supine and erect)
  > supine film feature = distended loops of bowel
  > erect film feature = air fluid levels