Intestinal Obstruction

Question 1

What is Intestinal Obstruction?

Answer 1

A partial or complete obstruction of the small or large intestine.

Question 2

Intestinal Obstruction S&S?

Answer 2

• Cramping pain
• Pain intermittent and colicky
• Abdominal distension
• Nausea and vomiting
• Jelly stools
• obstipation
• Tachycardia
• Fever
• Faecal vomiting
• Bile stained vomiting
• increased bowel sounds
• visible peristalsis or loops of bowel
• scars

Question 3

What are the two types of bowel obstruction?

Answer 3

Mechanical and pseudoobstruction

Question 4

What are the five kinds of mechanical obstruction?

Answer 4

• Adhesion (two pieces of bowel fuse together)
• Tumour - (colorectal cancer)
• Intersusception (folds in on itself)
• hernia
• volvulus (twisting of intestine segment)

Question 5

What are the two types of pseudoobstruction?

Answer 5

• Myopathy - problems with muscle, no peristalsis
• Neuropathy - no innervation = no peristalsis
• Hirschsprung Disease - missing nerves

Question 6

What occurs in a bowel obstruction?

Answer 6

-Food accumulates behind obstruction
-Bacteria breaking down food produce gas
-Gas = bowel distension
-Bowel distension aggravated by air intake
1)
-Bowel distension = venous compression = decreased oxygenation
-lack of O2 = necrosis = reduced peristalsis which aggravates distension
-Bacteria and toxins released by dying cells enter circulation = Sepsis
2) Bowel distension = venous compression = fluid secretion into bowel = Loss of H20 = loss of electrolytes = Hypotension = Shock

Question 7

What does bowel distension trigger and what does this exacerbate?

Answer 7

Vomiting which contributes to loss of H20 = Shock

Question 8

What are the three complications of bowel obstruction?

Answer 8

1. Bowel Ischaemia
2. Bowel perforation
3. Sepsis

Question 9

What does venous ischaemia result in?

Answer 9

Tissue necrosis = cell death and subsequent release of toxins
Also allows bacteria into circulation increasing toxicity.

Question 10

What is gut perforation?

Answer 10

Bowel distenion continues untreated until wall weakness and pressure cause rupture of gut wall releasing bowel contents into peritoneum. Can cause peritonitis

Question 11

Discuss Sepsis as a result of bowel obstruction?

Answer 11

Secretion of toxins into blood or by bowel perforation can result in sepsis.