Small And Large Bowel Obstruction

Question 1

Presentation of bowel obstruction

Answer 1

• abdominal pain w/ peristalsis
• distension
• N/V
• constipation
• abnormal sounds

Question 2

Biggest 3 causes of bowel obstruction

Answer 2

• adhesions
• hernias
• malignancy

Question 3

What cancer increases the risk of obstruction

Answer 3

Colorectal

Question 4

How does volvulus lead to obstruction

Answer 4

• loops

- twists

Question 5

Other causes of large bowel obstruction

Answer 5

• diverticulitis

- incarcerated hernias

Question 6

List potential cause of small bowel obstruction

Answer 6

• adhesions
• intussusception
• inguinal hernia
• GS ileus

Question 7

Why does Peutz-Jeghers syndrome cause small bowel obstruction

Answer 7

Gastro polyps

Question 8

Appearance of Peutz-Jegher’s syndrome

Answer 8

Brown spots on skin

Question 9

Auscultation findings

Answer 9

• tinkling hyperactive sounds

- absent

Question 10

PR findings

Answer 10

Empty rectum

Question 11

XR findings

Answer 11

• coffee bean —> sigmoid

- embryo —> caecal

Question 12

General Mx of obstruction

Answer 12

• anti-emetics
• analgesia
• fluids

Question 13

Small bowel obstruction Mx

Answer 13

• fluid

- NG tube

Question 14

Large bowel obstruction Mx

Answer 14

• surgical
• laparoscopic resection
• 1ry anastomosis

Question 15

Sigmoid volvulus Mx

Answer 15

Decompressed

Question 16

Caecal volvulus Mx

Answer 16

• laparotomy

- iliocaecal resection

Question 17

Hartman’s procedure in diverticular disease Mx

Answer 17

Sigmoid colectomy + end colostomy

Question 18

Abx given if surgery

Answer 18

• ampicillin

- gentamicin