Large Bowel Obstruction Flashcards
Is this less or more severe than small bowel obstruction?
Less Severe
Symptoms present more gradually
Causes of Large Bowel Obstruction?
Colon Cancer Intusussception Benign Strictures Sigmoid Volvulus Hernia Pseudo-Obstruction?
What is Pseudo-Obstruction?
Like paralytic ileus but of the large bowel
Presentation of Large Bowel Obstruction?
Symptoms come on more gradually
- Abdominal Distension
- Constipation
- Vomiting (Faculent)
- Colickly Abdominal Pain
What is ‘Absolute Constipation’?
How does it cause pain?
This is when no bowel contents pass out (No faeces or gas)
It causes pain due to bowel distension and peristalsis trying to overcome the obstruction
What are the types of Obstruction in the large Bowel?
Closed Loop
Incompetent Ileo-Caecal Valve
Incomplete Obstruction
Describe Closed Loop Obstruction?
The ileocaecal valve is competent
Allows material to flow into the large bowel and prevents backflow
The colon becomes massively distended and the caecum is at risk of rupture
Describe Incompetent Ileo-Caecal Valve Obstruction
The ileo-caecal valve is incompetent
Backflow of material occurs
This causes distended small bowel and large bowel
Risk of perforation is less and the symptoms are more gradual
Describe incomplete obstruction?
There is intermittent vomiting and erratic bowel habits
Causes colicky pain
Describe the physical signs of Obstruction?
Dehydration
Abdominal Distension
No Tenderness
High pitched tinkling bowel sounds
Investigations
Supine Abdominal XRay
Management
NG Tube to decompress
Nil by mouth
Fluids
IV Access
