large Bowel Obstruction Flashcards
what are some causes of large bowel obstruction?
- colorectal cancer
- functional bowel disorders
- Volvulus- sigmoid or caecal
- pseudo-obstruction
- faecal impaction
what are the symptoms and signs? 4
- abdominal distension
- constipation
- pain
- vomiting
what is important to note about vomiting?
when it came on,
This may be the first symptom if it is an upper small bowel obstruction
May be the last symptoms in distal rectal obstruction
what are the symptoms and signs in ileus or mechanical obstruction?
There is no pain and bowel sounds are absent
diagnosis?
need to do a rectal exam
_____ and large bowel obstruction require surgery
strangulation
___ and incomplete small bowel obstruction may be managed conservatively
Ileus and incomplete small bowel obstruction may be managed conservatively
who tends to get sigmoid volvulus
elderly
how is sigmoid vovulus diagnosed?
Plain X-ray abdo
Rectal contrast
what is the 1st line treatment for sigmoid volvulus with no peritonitis or mucosal gangrene?
1st line: flexible or rigid sigmoidoscopy- Insertion of a flatus tube
what is the 1st line treatment for sigmoid volvulus with peritonitis or mucosal gangrene?
surgery
what happens in pseudo-obstruction?
These patients present with all the signs of obstruction but don’t have a mechanical cause
what may cause pseudo obstruction?
hypoxia or biochemistry abnormalities
who gets pseudo-obstruction?
elderly/debilitated
who gets faecal impaction?
Happens in bed ridden, elderly patients
