Medbear IO

Question 1

State the most common cause of small bowel obstruction

Answer 1

• Adhesion
• Hernia
• Strictures
• Cancers

Question 2

State the common cause of large bowel obstruction

Answer 2

• Cancers
• Diverticular disease
• Volvolus

Question 3

Describe on the pathophysiology of IO

Answer 3

Simple obstruction -> bowel ischemia -> Gangrenous bowel -> Perforation
- Characterized by collapse of bowel distal to obstruction with proximal dilatation
1. Gas accumulation
2. Fluid accumulation -> due to impaired absorption from gut

If obstruction not resolved (e.g strangulated bowel) -> proximal bowel dilation increases -> compromising venous return -> increased capillary pressure -> compromise arterial supply leading to ischemia
Bowel -> hemorrhagic infarction
Bowel perforation -> peritonitis, sepsis and maybe septic shock

Question 4

State (4) cardinal symptoms of IO

Answer 4

• Pain
• Vomiting
• Abdominal distension
• Constipation/Obstipation (severe form of constipation that results a person unable to have bowel movement)

Question 5

What history in IO is suggestive of complications?

Answer 5

• Worsening abdominal pain
• Fever
• GI bleeding

Question 6

List 2 types of intestinal obstruction

Answer 6

1. Mechanical (peristalsis working against a mechanical obstruction)
2. Functional (absence of peristalsis without obstruction)

Question 7

State some differentials for the mechanical cause of IO

Hints:
- Intra-luminal
- Intra-mural
- Extra-mural

Answer 7

Question 8

Explain a bit on SMA syndrome seen in extramural cause of IO

Answer 8

• Occurs in young patient
• Presented with abdominal pain, nausea and vomiting
• Pathophysiology: rapid weight loss -> loss of duodenal fat pad resulting in narrowing of aorta-mesenteric angle