Bowel Obstruction Flashcards
What are the common causes of small bowel obstruction?
Adhesions
Herniae
What are the common causes of large bowel obstruction?
Malignancy
Diverticular Disease
Volvulus
What are the intraluminal causes of bowel obstruction?
Gallstone illeus
Ingested foreign body
Faecal impaction
What are the mural causes of bowel obstruction?
Tumour Inflammatory strictures Diverticular strictures Meckel's Diverticulum Lymphoma
What ate the extramural causes of bowel obstruction?
Adhesions
Hernias
Intussusception
What are the cardinal features of bowel obstruction?
Abdominal pain - colicky
Vomiting
Abdominal Distension
Absolute Constipation
What is an adynamic cause of bowel obstruction?
Paralytic Illeus
What happens proximally to bowel obstruction?
Increased peristalsis
Bowel dilates - gas and fluid accumulate in abdomen
Decreased peristaltic strength - stretched muscle
Bowel sounds in bowel obstruction
High-pitched/tinkling
Then silent
Small bowel obstruction x-ray
Dilated bowel >3cm
Central abdominal location
Valvulae conniventes visible
Large bowel obstruction x-ray
Dilated bowel >6cm
Peripheral location
Haustra lines visible
Conservative management of bowel obstruction
NBM
Drainage via NG tube
Analgesia + anti-emetics
IV fluids
What is a volvulus?
Axial rotation og loop of intestine around its mesentery
Risk factors of volvulus
Increasing age
Chronic constipation
Male
Previous abdo surgery
Volvulus x-ray
Sigmoid = coffee bean sign
Dial like shadow
