SBO and LBO*

Question 1

What is the most common type of bowel obstruction

Answer 1

SBO

Question 2

What are the causes of SBO

Answer 2

Surgical adhesion (mc)
Crohn’s
Strangulating hernia
Malignancy

Question 3

What are the presentations of SBO

Answer 3

Vomit then Constipation
Mild abdo situation w/ pain
Tinkle bowel sounds

Question 4

What are the causes of LBO

Answer 4

Malignancy (mc)
Volvulus (Colon twisting)
Intusseption (Colon folding on itself)

Question 5

What are the presentations of LBO

Answer 5

Constipation then vomiting
Gross distention w/ pain
Hyperactive -> normal -> Absent bowel sounds

Question 6

How does the presentation differ between SBO and LBO

Answer 6

SBO = V then C (Mild pain)
LBO = C then V (Major pain)

Question 7

How is bowel obstruction diagnosed

Answer 7

1st = Xray (Dilated bowel loops and Transluminal gas shadows)
Gold = CT ABDO

Question 8

What is the gold standard investigation for Bowel obstruction

Answer 8

CT Abdo

Question 9

What can be seen on an Xray of the bowels

Answer 9

Dilated bowel loops

Transluminal. Gas Shadows

Question 10

What can be seen in SBO and not in LBO Xray

Answer 10

Coffee bean sign (Sigmoid volvulus)

Question 11

How is Bowel obstruction treated

Answer 11

Fluid Resuc.
NG tube
Antiemetics w/analgesia
Abx
Surgery

Question 12

What is pseudo bowel obstruction

Answer 12

No mechanical obstruction

Post operative

Question 13

What is Hirsch Poung Disease

Answer 13

Congenital lack of colon nerve supply

-Typically LBO