Intestinal obstruction

Question 1

Intestinal Obstruction meaning + cause

Answer 1

• ## Partial or complete obstruction of the intestinal lumen of the small or large bowelcauses:
• Abdominal surgery with adhesions
• Congenital abnormalities of the bowel
• Carcinoma (primary, metastatic)
• Fluid & electrolyte losses associated
  with colonic obstruction < small bowel.ie small obstruction more common than large

Question 2

which drugs should NOT be used in IO?

Answer 2

bulk forming laxatives: psyllium
5HT4 receptor antagonist: prucalopride

Question 3

IO can be __ or __ causes

Answer 3

Mechanical or functional

Question 4

list the 8 mechanical/physical and 4 functional causes of IO

Answer 4

Mechanical: post-op adhesions, intussusception(telescoping), hernias, volvulus (Abnormal twisting of a portion of the gastrointestinal tract), strictures and fibrous bands, tumour, fecal impactation, injest foreign body

Functional (less smooth muscle contractility): post-op ileus (COMMON), infections-inflammations (appendicitis, hypothyroidism, intestinal ischemia), electrolyte abnormalities (hypokalemia, hypocalcemia), opoid medication (opoids)

Question 5

The most common functional IO cause is: ?

Answer 5

postoperative ileus (The inability of the intestine to contract normally leading to a build-up of food material. ;trauma)

Question 6

On assessment of the abdomen in a patient with peritonitis, you would expect to find:
(a) a soft abdomen with bowel sounds every 2 to 3 seconds.
(b) rebound tenderness and guarding.
(c) hyperactive, high-pitched bowel sounds and a firm abdomen.
(d) ascites and increased vascular pattern on the skin.

Answer 6

A

Question 7

Patients with a paralytic ileus typically have:
(a) intravenous fluid replacement and a nasogastric tube connected to suction.
(b) surgical correction of the problem.
(c) endoscopic injection of botulinum toxin or esophageal dilation.
(d) endoscopy to allow biopsy followed with broad-spectrum antibiotics.

Answer 7

A