Intestinal obstruction Flashcards
What is intestinal obstruction?
A blockage in the intestines that prevents the normal passage of food, fluids, and gas.
What are the two main types of intestinal obstruction?
Mechanical obstruction (physical blockage) and functional obstruction (paralytic ileus, where the intestines stop moving).
What are common causes of mechanical obstruction?
Adhesions (scar tissue from surgery)
Hernias (intestine trapped in a weak spot of the abdominal wall)
Tumors
Volvulus (twisting of the intestine)
Intussusception (telescoping of one part of the intestine into another)
Impacted stool (fecal impaction)
What are causes of functional obstruction (paralytic ileus)?
Post-surgical complications
Electrolyte imbalances (e.g., hypokalemia)
Infections (e.g., peritonitis, sepsis)
Medications (opioids, anticholinergics)
Neurological disorders (e.g., Parkinson’s disease, spinal cord injury
What are the common symptoms of intestinal obstruction?
Severe abdominal pain (crampy or colicky)
Distension (bloating)
Nausea & vomiting (especially bilious vomiting if high obstruction)
Constipation or inability to pass gas
High-pitched bowel sounds (early) or absent bowel sounds (late)
What symptom suggests a complete obstruction?
Absolute constipation (no stool or gas passage).
What symptom suggests small intestinal obstruction?
Nausea/vomiting, passing stool in early stages
What symptom suggests strangulation of the bowel?
rebound tenderness, fever, tachycardia
What imaging studies are used to diagnose intestinal obstruction?
Abdominal X-ray (dilated loops of bowel, air-fluid levels)
CT scan (more detailed, identifies cause and complications)
Ultrasound (useful in children, especially for intussusception)
What lab findings might indicate complications?
Leukocytosis (↑ WBCs) → Infection or ischemia
Electrolyte imbalances → Vomiting-related losses
Lactic acidosis → Possible bowel ischemia
ABG → Looks for complications
What are the initial management steps for intestinal obstruction?
NPO (nothing by mouth)
IV fluids for hydration and electrolyte correction
Nasogastric tube (NG tube) for decompression
Pain management (avoid opioids if possible)
When is surgery required for intestinal obstruction?
Strangulation (ischemia, necrosis)
Failure of conservative management
What are potential complications of untreated intestinal obstruction?
Bowel ischemia & necrosis
Perforation → peritonitis
Sepsis & multi-organ failure
What is a key sign of bowel perforation?
Sudden severe abdominal pain with rigid abdomen and absent bowel sounds
How would you describe small intestines on AXR?
small
smaller lumen
centrally located
Plica circularis
How would you describe large intestines on AXR?
larger
peripherally located (ascendine, transverse, descending)
Haustration on x-ray
(circular folds)
