Intestinal obstruction Flashcards
Define intestinal obstruction
Obstruction of normal bowel movements
Classification of intestinal obstruction
3
Small or large bowel
Partial or complete obstruction
Simple or strangulated
Classification of aetiology of intestinal obstruction
3
Extramural
Intramural
Intraluminal
Aetiology of intestinal obstruction - extramural
4
Hernia
Adhesions
Bands
Volvulus
Aetiology of intestinal obstruction - intramural
2
Tumours
Inflammatory strictures
Aetiology of intestinal obstruction - intraluminal
2
Pedunculated tumours
Foreign body
Epidemiology of intestinal obstruction
prevalence, age
COMMON
More common in the elderly due to increased incidence of adhesions, hernias & malignancy
Presenting symptoms of intestinal obstruction
4
Severe gripping colicky pain w/ periods of ease
Abdominal distention
Frequent vomiting - may be bile stained or faeculent
Absolute constipation
Signs of intestinal obstruction on physical examination
7
Abdominal distention w/ generalised tenderness
May see visible peristalsis
Tinkling bowel sounds
Peritonitis - absent bowel sounds, guarding, rebound tenderness
Inspect for hernias
Look for abdominal scars
Inspect for abdominal mass (e.g. intussusception, carcinoma)
Investigations for intestinal obstruction
3
AXR
Water-soluble contrast enema
Barium follow through
Investigations for intestinal obstruction - AXR
2
Assists diagnosis & localisation
Check for calculate conniventes (small bowel) or hausfrau (large bowel)
Management of intestinal obstruction
2
General
Surgical
Management of intestinal obstruction - general
4
Gastric aspiration via NG tube if patient is vomiting
IV fluids
Electrolyte replacement
Monitor vital signs, fluid balance, urine output
Management of intestinal obstruction - surgical
1
Emergency laparotomy in acute obstruction
Complications of intestinal obstruction
5
Dehydration Bowel perforation Peritonitis Toxaemia Gangrene of ischaemic bowel wall
