Bowel Obstruction

Question 1

Extrinsic mechanical causes

Mech means nat cause physical obstruc

Answer 1

Adhesions
Hernia
Intra or extra int cancer
Intra abdo abcess

Question 2

Intrinsic mech causes

Answer 2

Malrotation
Duplications, cysts
Crohns
Infec- TB, actinomycosis, diverticulitis
Prim or met neoplasm- carcinoma, lymphome, carcinoid
Haematoma from trauma
Ischaemic stricture
Intussusception
Endometriosis
Radiation enteropathy or stricture

Question 3

Intraluminal mech cause

Answer 3

Gallstone
Enterolith, fecal impaction
Bezoar
FB

Question 4

Functional (ileus) causes

No mech blockage, inadeq peristalsis

Answer 4

Post laparotomy
Metabolic and electrolyte imbal eg hypoK,Mg,Na, uraemia, DM koma.
Drugs eg opiate, anticholinergics, psychotropic
Intra abdo inflamm
Retroperit inflamm or haemorrhage
Systemic sepsis

Question 5

SI most common causes

Answer 5

Adhesions- surg, trauma, infec
Hernias
Tumours- GIST, carcinoid, lymphoma. Mets eg ovary, colorectal, stom
Crohns

Question 6

SI px

Answer 6

Abdo pain, paroxysms ev 4-5 min
Vom, faeculent
Obstipation
Distension
Fail flatus
Visible peristalsis
Hernia/scar
High tinkling bowel sounds
Dehyd
Tachy
Hypot
Fever
Tenderness

Question 7

SI and LI ix are the same

Answer 7

FBC, clotting, GS, UE, LFT, ABG
Plain AXR, CXR
Barium meal and follow through
MRI

Question 8

SI mx

Answer 8

Fluids
NG tube
Catheter
Adhesions us self resolve. Surg if fever, peritonitis, perforat, refractory
Surg for non adhesional

Question 9

LI most comm causes

Answer 9

Colorectal carcinoma
Diverticular dis
Vovlulus

Question 10

LI px

Answer 10

Like SI but
Vom inconcspicuous
Longer btw pain paroxysms
May be rectal mass

Question 11

LI mx

Answer 11

Fluid
Catheter
Sigmoid volvulus norm fixed by colonoscopy
Surg or stent for all other causes