Gastro - Intestinal Obstruction

Question 1

What is intestinal obstruction?

Answer 1

Physical obstruction prevents flow of faeces through intestines

Question 2

What does intestinal obstruction lead to?

Answer 2

Blockage leads to back-pressure through GI system causing
- Vomiting
- Absolute constipation
- Inability to pass flatus

Question 3

What are some causes of intestinal obstruction?

Answer 3

Meconium ileus
Hirschsprung’s disease
Oesophageal atresia
Duodenal atresia
Intussusception
Imperforate anus
Malrotation of intestines with volvulus
Strangulated hernia

Question 4

How does intestinal obstruction present?

Answer 4

Persistent vomiting - may be bilious, containing bright green bile
Abdominal pain
Abdominal distension
Inability to pass flatus
High pitched tinkling bowel sounds

After some time, absent bowel sounds

Question 5

How is intestinal obstruction diagnosed?

Answer 5

Abdominal xray

• Shows dilated loops of bowel proximal to obstruction
• Collapsed loops of bowel distal to obstruction
• Absence of air in rectum

Question 6

How is intestinal obstruction managed?

Answer 6

Emergency referral to paediatric surgical unit

Initial management
Nil by mouth
NG tube- to drain stomach and stop vomiting
IV fluids - dehydration and electrolytes

Surgical management