Intestinal Bowel Obstruction

Question 1

Types of intestinal obstruction

Answer 1

Dynamic (physical) (hyperperistalsis)
Adynamic (non contracting bowel wall)( silent obstruction)

Question 2

Silent abdomen is seen in

Answer 2

Adynamic obstruction

Dynamic
(Perforation or strangulation developed)

Question 3

Cardinal features of obstruction

Answer 3

Pain ( coliky)
Abdominal distension
Vomiting
Non passage of flatus and featua (OBSTIPATION)

Question 4

Initial investigation in bowel obstruction

Answer 4

Xray abdomen

Erect and supine

Question 5

Level of obstruction is known by

Answer 5

Erect x ray >3 levels obstruction

Question 6

Site of obstruction is known by

Answer 6

Supine x ray

Question 7

Jejunum in supine x ray of intestinal obstruction

Answer 7

Cocertina effect
Stepladder pattern
Complete volvulus
Feathery app

Question 8

Ileal loops

Answer 8

Featureless lopp of WANGENSTEIN

Question 9

Large bowel obstruction findings

Answer 9

Periphery
Haustrations are incomplete

Question 10

3,6’9 rule

Answer 10

3cm-small intestinal

6cm-large intestinal

9cm-caecum

Question 11

IOC of bowel obstruction

Answer 11

ADULTS–Contrast enhanced Computed tomography (CECT)

CHILDREN–USG

Question 12

Management

Answer 12

IV fluids (Ringer lactate)
Nasogastric tube / reyles tube
IV antibiotics (gram -ve, anaerobes)
Painkillers

Question 13

Majority of distension in BO patients is due to

Answer 13

Swallowed air

Question 14

Surgery for intestinal obstruction

Answer 14

Exploratory laprotomy

Question 15

First structure which we look at during exploratory laprotomy

Answer 15

Caecum

Caecum collapsed (SI obstruction)
Caecum distended (LI Obstruction)

Question 16

Viable bowel character

Answer 16

Healthy pink
Mesentric pulsations
Stimulating causes peristalsis