Bowel obstruction

Question 1

What are the symptoms of intestinal obstruction?

Answer 1

vomiting
pain
constipation
distention

Question 2

How does vomitus indicate the site of obstruction?

Answer 2

gastric outlet - semi-digested food

bile-stained fluid - upper small intestine

thick, foul smelling (faeculent) - distal obstruction

Question 3

What is the best investigation for a suspected bowel obstruction?

Answer 3

Supine abdominal X-ray

Question 4

Causes of bowel obstruction?

Answer 4

adhesions or bands
incarcerated abdominal wall hernia
internal hernia
volvulus
tumour
inflammatory strictures
bolus obstruction
intrussception

Question 5

What are the common causes of inflammatory strictures of the bowel?

Answer 5

Crohn’s disease

Diverticular disease

Question 6

Obstruction of the small intestine is a common complication of…

Answer 6

Crohn’s disease

Question 7

Diverticular disease usually affects what part of the colon?

Answer 7

Sigmoid colon - obstruction occurs there

Question 8

What is intussusception?

Answer 8

A segment of the bowel becomes telescoped into the segment distal to it.
-initiated by a mass in the bowel wall

Question 9

What is adyndamic bowel obstruction?

Answer 9

Disruption of the normal propulsive activity of the GI tract

• ileus (post-op, peritonitis, diabetic keto-acidosis)
• pseudo-obstruction (Ogilvie’s syndrome)