Bowel obstruction

Question 1

Sigmoid volvulus?

Answer 1

Coffee beam sign on AXR

Question 2

Gastric outlet obstruction/

Answer 2

Vomiting of semi undigested food with no bile.

Question 3

Small bowel obstruction?

Answer 3

Acute onset (hours)
Severe abdominal pain 
Copious amounts of bile stained vomit.

Question 4

Large bowel obstruction presentation?

Answer 4

More insidious onset.
More likely to present with constipation.
May have faeculaent vomit.

Question 5

Small bowel obstruction on axr

Answer 5

Central loops of dilated bowel with valvulae coniventes that do not go all the way across.

Question 6

Large bowel obstruction on AXR?

Answer 6

Peripherally dilated bowel with haustra that do not go all the way across.

Question 7

1st line investigation for obstruction?

Answer 7

AXR

Question 8

Definitive diagnostic test?

Answer 8

CT Abdo.

Question 9

What bloods would you ask for in an acute abdomen?

Answer 9

FBC, U&e, LFT, Coagulation, CRP, amylase, group and save, +/- culturre, ABG

Question 10

What is the gold standard imaging for the abdomen?

Answer 10

CT

Question 11

Conservative managament of bowel obstruction/

Answer 11

Drip anmd suck, fluid resus + NG tube.