Obstruction of the Bowel

Question 1

What causes obstruction of the Small bowel? (2)

Answer 1

Adhesions and Hernias

Question 2

What causes obstruction of the large bowel? (4)

Answer 2

Colon cancer, constipation, diverticular disease, volvulus

Question 3

What else can cause either small or large?

Answer 3

Ileus/motility disorder of the bowel

Question 4

What is a simple obstruction?

Answer 4

One obstructing point with no vascular compromise

Question 5

What is a closed loop obstruction?

Answer 5

Obstruction at 2 points forming a loop of distended bowel

Question 6

What are the risks with closed loop obstruction?

Answer 6

Risk of perforation

Question 7

What is a Strangulated obstruction?

Answer 7

Blood supply is compromised

Question 8

Symptoms (5)

Answer 8

Vomiting (faeculent vomiting), nausea, anorexia, colic, constipation

Question 9

Signs (2)

Answer 9

Abdominal distension, tinkling bowel sounds

Question 10

Investigations (4)

Answer 10

Abdominal X-ray, CT scan, PR exam, Bloods (FBC=WCC)

Question 11

First line treatment

Answer 11

Surgery to remove obstruction

Question 12

Other Treatment (5)

Answer 12

Analgesia, NG tube, IV fluids, Catheterisation, enemas/suppositories if constipated

Question 13

Complications (3)

Answer 13

Perforation, toxic megacolon, ischaemic bowel disease