Presentation, diagnosis and management of bowel obstruction Flashcards
What will happen to the GI tract proximal to the obstruction
Dilates
Describe the presentation of a small bowel obstruction
Acute presentation
Hours of onset
Large volumes vomited
What are the presentation of a distal small bowel / large bowel obstruction
Colicky abdominal pain and distension
Vomiting (possibly faeculent)
Describe the vomit of a gastric outlet obstruction
Semi-digested food eaten a day or two previously - no bile
Describe the vomit of an upper small bowel obstruction
Copious bile-stained fluid
Describe the vomit of a more distal obstruction
Thicker
brown
foul smelling
Faeculent
What causes colicky pain
Peristalsis attempts to overcome the obstruction
What is absolute constipation
Neither faeces of flatus is passed rectally
What are signs of incomplete obstruction
Vomiting may be intermittent
Bowel habit erratic
Gradual hypertrophy of the muscle of the bowel wall proximally is a sign of what
Chronic incomplete obstruction
What are some clinical signs of intestinal obstruction
Bowel sounds are high pitched and tinking
What investigations should be done ofr a suspected bowel obstruction
AXR
CT
How do we manage an intestinal obstruction
NBM
Insert IV cannula and send blood
Resuscitate with IV fluids, replacing electrolyte losses
Pass an NG tube to decompress the stomach
What are some mechanical causes of bowel obstruction
Adhesions or bands Internal hernia Volvuus Tumour Inflammatory strictures
What is the most common cause of large bowel obstruction
Cancer
