Small Bowel Obstruction pg 2258

Question 1

what are the two main subcategories of SBO?

Answer 1

Mechanical
adynamic ileus aka paralytic ileus

Question 2

what are the two most common causes of SBO in the US?

Answer 2

adhesions

second most common: hernias

Question 3

S/S of SBO?

Answer 3

crampy, intermittent pain
typically feel the urge to move and unable to find comfortable position
intermittent pain due to peristalsis
distention
vomiting (bilious in character if its proximal, feculent if distal ilium is obstructed)
possible diarrhea
tympanic abdomen
“tinkling” or high pitched bowel sounds on auscultation

Ileus will have less intense pain and is more constant.

Question 4

Labs for SBO

Answer 4

CBC, CMP

Question 5

gold standard for imaging of an SBO

Answer 5

upright abdominal x ray

Question 6

management and treatment of SBO

Answer 6

(all patients-mechanical and ileus)

NPO
D/C meds that cause motility issues
NG
2 site IV access

Mechanical: will need surgery

Question 7

surgery with SBO is likely needed if:

Answer 7

gangrene or necrosis (WBC’s 20,000)
intrinsic mechanical cause
failure of conservative therapy

Question 8

disposition of SBO

Answer 8

MEDEVAC and General Surgery Consult