Intestinal Obstruction

Question 1

What causes mechanical intestinal obstruction?

Answer 1

1- post laparotomy

2- from incarcerated hernia

Question 2

What are the S&S for intestinal obstruction?

Answer 2

1- colicky abdominal pain

2-no passage of gas of feces( high pitched bowl sound, after few days it becomes silent) ➡️ Abd. Distention ➡️ vomiting

Question 3

How to diagnose intestinal obstruction?

Answer 3

X-ray: shows distended small bowel with air-fluid level

Question 4

How to 💊 intestinal obstruction?

Answer 4

1. NPO, NG suction & IV fluids ( hoping for spontaneous resolution)
2. Surgery is done if conservative management didn’t work
   ( in complete obstruction = surgery within 24hours, if partial within few days )

In strangulated obstruction ➡️ emergency surgery is done

In obstruction caused by hernia:
Surgery is the ttt:
Urgent : in case ofstrangulation
Elective : in case of viable bowel that reduced manually

Question 5

What are the additional S&S that tell you the obstruction is now strangulated?

Answer 5

1. fever
2. Leukocytosis
3. Constant pain, tenderness
4. Signs of peritoneal irritation
5. peritonitis & sepsis ( lastly)