Intestinal obstruction

Question 1

What are causes of mechanical intestinal obstruction in small bowel?

Answer 1

Adhesions
Hernias
Crohns 
Intussusception
Cancer

Question 2

Causes of mechanical intestinal obstruction in large bowel?

Answer 2

Colon carcinoma
Diverticular stricture
Volvulus

Question 3

Describe pathology of a mechanical obstruction?

Answer 3

Bowel above the level of obstruction is dilated, with increased secretion of fluid into the lumen

Question 4

Symptoms of a mechanical obstruction

Answer 4

Colicky abdominal pain
Vomiting
Absolute constipation

Question 5

Signs of mechanical bowel obstruction

Answer 5

Distention

Tinkling bowel sounds

Question 6

Small bowel mechanical obstruction may settle with conservative management, what would such management consist of?

Large bowel mechanical obstruction has to be treated surgically

Answer 6

Nasogastric suction

IV fluids for hydration

Question 7

What is intussusception?

Answer 7

part of the intestine invaginates (folds into) into another section of intestine,

Question 8

Describe functional obstruction

What are the two types

Answer 8

Pain not present
Bowel sounds decreased
Gas seen throughout bowel on AXR

Paralytic ileus (absence of peristaltic contractions)
Pseudo-obstruction (mechanical obstruction with no cause found)

Question 9

Treatment for functional bowel obstruction

Answer 9

Neostigmine (improves muscle tone)

Colonoscopic decompression

Question 10

How does neostigmine work

Answer 10

Inhibits ACh breakdown–> improves muscle tone