bowel obstruction Flashcards
what sort of bowel sounds would you get in bowel obstruction?
tinkling bowel sounds
absent bowel sounds?
ileus
causes of bowel obstruction outside the bowel?
adhesions, hernia, tumour compression (external masses)
what is the most common cause of bowel obstruction?
adhesions
causes of bowel obstruction inside the bowel?
tumours, intucusseption, strictures (crohns/UC), bous obstruction (faeces, food bolus, gallstone illeus)
what part of the bowel is mobile and likely to war around itself?
sigmoid
which valve can on obstruction occur in
iliocaecal valve incometence (faeces cannot move backwards to relieve the pressure)
what is an adynamic bowel due to absence of normal peristalsis called?
illeus
acute colonic pseudo obstruction. what is the name of this syndrome?
Ogilvie syndrome
if its a volvulus, what might the nature of the tenderness be?
may be more localised over site
tinkling bowel sounds? absent bowel sounds?
tinkling - obstruction
absent - ileus
More acute onset of symptoms over hours.
Severe abdominal pain, with copious amounts of bile stained vomit with minimal distension
small bowel
Vomitus of semi digested food with no bile.
gastric outlet obstruction
More insidious onset of symptoms.
Absolute obstruction, abdominal colic with obvious distension and later onset of minimal vomit +/- feculent vomit.
Absolute obstruction indicates more distal obstruction.
large bowel obstruction
what is the coffee bean sign on x ray ?
sigmoid volvulus
Severe, constant pain.
Peritonitis + fever and raised white cells.
strangulated bowel
what would you see on a CXR from bowel perforation?
on erect x ray you would see air under diaphragm
what test is carried out to identify cause of obstruction n?
CT
if wind is still being passed, is this complete or incomplete obstruction ?
incomplete
why do you fluid resuscitate in bowel obstruction ?
provide rest for bowels and allows correction of electrolyte imbalance
