mechanism bowel obstruction

Question 1

Name 3 causes of bowel obstruction?

Answer 1

1. adhesions from scar tissue
2. Hernias
3. Malignancy

Question 2

What is ‘closed loop obstruction’?

Answer 2

1. large bowel contents distend the wall
2. competent iliocecal valve prevents reflux
3. risk of perforation instead

Question 3

What are complications of bowel obstruction?

Answer 3

1. reflux of contents - vomitting

2. Strangulation and subsequent periotnitis

Question 4

What are the 4 main clinical features?

Answer 4

1. colicky abdominal pain
2. abdominal distention
3. vomitting
4. absolute constipation - no faeces or flatus

Question 5

What is a sign of bowel obstruction?

Answer 5

‘tinkling’ bowel sounds

Question 6

What is the key Ix and what does it show?

Answer 6

Plain abdominal radiograph

- distended loops of bowel

Question 7

Name further investigtions for bowel obstruction?

Answer 7

1. Bloods - FBC and Uand E

2. CT scan to confirm site and nature of obstruction

Question 8

Conservative Mx of bowel obstruction?

Answer 8

‘Drip and suck’

1. nil by mouth
2. IV fluids
3. NG tube to aspirate stomach contents

Question 9

Surgical Mx

Answer 9

indicated to treat underlying cause;

1. adhesiolysis to treat adhesions
2. repair hernia
3. strangulation - surgery within 1 hour