Bowel Obstruction Flashcards
How does small and large bowel differ in terms of pain?
Small - pain is radiated to periumbilical region
Large - pain is radiated to the hypogastrium/lower obstruction
How does the picture of vomiting differ in small and large bowel obstruction?
Small - vomiting early
Large - Vomiting late once the abdomen is very distented, and only if the iliocaecal valve is incompetent
How is the pain described in obstructions?
Dull with collicky waves every (10 mins)
Non-localised
Not worse with coughing or bumps
How do bowel actions appear in bowel obstruction?
Large: cessation of bowel motions and flatus
Small: May have a few more actions with the emptying of the colon
Which type of obstruction causes more/quicker distention?
Large
What are important questions to ask on Hx for ?bowel obstruction?
Previous abdo surgery
Previous obstructions
Constitutional symptoms of cancer
Changes in bowel motions
What is GIST?
Gastrointestinal stromal tumour
What are some causes of small bowel obstructions?
Adhesions (70%)
Herniae
Extrinsic compression
Ileus
Internal hernia/Volvulus
Crohn’s
Intussusception
Who tends to get femoral hernia’s?
Women
Skinny
Recent weight loss
What are some causes of large bowel obstructions?
Ca
Diverticular strictures
Pseudo-obstruction
Sigmoid volvulus
Severe constipation
What is the narrowest location in the GIT?
Ileocaecal valve
What is a pseudo-obstruction? Who gets them?
Symptoms of a obstruction without a mechanical cause
Systemically ill
Spinal patients
Congenital
What are xray findings for bowel obstruction?
Multiple fluid air levels
Bowel distention
No gas post obstruction
When do you CT a small bowel obstruction?
When the aetology is not obvious
How do you Ix a large bowel obstruction?
CT abdo
