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SURGICAL DISEASES > TH4 - INTESTINAL OBSTRUCTION > Flashcards

TH4 - INTESTINAL OBSTRUCTION Flashcards

1
Q

MECHANICAL OBSTRUCTION

A

Luminal content cannot pass through gut tube because lumen is blocked

> MECHANICAL BLOCK

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2
Q

FUNCTIONAL OBSTRUCTION

A

NEUROGENIC / FUNCTIONAL OBSTRUCTION
PROBLEM WITH FUNCTION > MOTILITY

Lumen content not able to pass through due to disturbance in motility and prevent peristalsis from one region to other gut region

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3
Q

SIMPLE OBSTRUCTION

A

INTESTINAL LUMEN PARTIALLY/ COMPLETELY OCCLUDED WITHOUT ANY CHANGES TO INTESTINAL BLOOD FLOW

NO PROBLEM WITH BLOOD FLOW

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4
Q

STRANGULATION OBSTRUCTION

A

BLOOD FLOW TO OBSTRUCTED SEGMENT IS COMPROMISED > TISSUE NECROSIS + GANGRENE

PROBLEM WITH BLOOD FLOW

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5
Q

OPEN LOOP OBSTRUCTION

A

INTESTINAL FLOW IS BLOCKED BUT PROXIMAL DECOMPRESSION POSSIBLE VIA VOMITING

PROXIMAL END OF LOOP = OPEN

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6
Q

CLOSED LOOP OBSTRUCTION

A

INFLOW + OUTFLOW OF LOOP BOTH END = BLOCKED

COMPLETE OBSTRUCTION WITH GAS + SECRETIONS TO ACCUMULATE IN LOOP WITHOUT ANY DECOMPRESSION PROXIMALLY/ DISTALLY

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7
Q

GENERAL SYMPS OF INTESTINAL OBSTRUCTION

A 
ABDOMINAL PAIN - COLICKY
NAUSEA 
VOMITING 
- SBO - BILE/FOOD VOMIT
- LBO - FECAL VOMIT 
CONSTIPATION
DEHYDRATION - DUE TO VOMIT
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8
Q

CHARACTER OF ABDOMINAL PAIN IN STRANGULATED OBSTRUCTION

A

> CRAMPY/ COLICKY PAIN = EARLY STAGE
progress to severe/ constant pain
strangulated loop in contact with inner aspect of abdominal wall > cause severe localised pain

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9
Q

CHARACTERISTIC OF X RAY FOR INTESTINAL OBSTRUCTION

A

DISTENDED GAS

FLUID FILLED LOOPS OF BOWL WITH FLUID LEVELS

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10
Q

STANDARD METHOD FOR IMAGE DX IN PX WITH INTESTINAL OBSTRUCTION

A

PLANE ABDOMINAL X RAY TAKEN IN ERECT + SUPINE POSITION

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11
Q

VOLVULUS

A

LOOP OF BOWEL TWISTED MORE THAN 180 deg. ABOUT AXIS OF ITS MESENTERY

> FORM OF CLOSED LOOP OBSTRUCTION
OBSTRUCTION + ISCHEMIA OF LOOP OCCURS

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12
Q

MOST COMMON SITE FOR VOLVULUS

A

SIGMOID COLON
65% OF CASES

HAPPENS MORE COMMON IN BED BOUND PX WITH NO MOBILITY + CHRONIC CONSTIPATION

COFFEE BEAN SHAPE SEEN ON X RAY

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13
Q

INTUSSUSCEPTION

A

ONE SEGMENT OF BOWEL TELESCOPES INTO ADJACENT SEGMENT

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14
Q

INTUSSESCEPTUM

A

SEGMENT WHICH INVAGINATE INTO INTUSSUSCIPIENS > RESULTS IN OBSTRUCTION + ISCHEMIC INJURY OF INTUSSUSCEPTING BOWEL

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15
Q

4 TYPES OF INTUSSUSCEPTION

A

1) ENTERIC
2) ILEOCOLIC
3) ILEOCECAL
4) COLONIC

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16
Q

CHILDREN ARE MOSTLY AFFECTED BY?

A

INTUSSUSCEPTION

17
Q

WHO IS MOSTLY AFFECTED BY INTUSSUSCEPTION?

A

CHILDREN

18
Q

PATHOLOGICAL CONDITION RELATED WITH INTUSSUSCEPTION

A

TUMORS
MAINLY > ADULTS
90% OF CASES

19
Q

GALLSTONE ILEUS

A

INTENSE INFLAMMATION SURROUNDING GALL BLADDER WITH GALL STONES IN LUMEN

FISTULA MAY DEVELOP BETWEEN BILIARY TREE + SMALL/ LARGE INTESTINE

STONE PASS THROUGH FISTULA + CAUSE OBSTRUCTION OF SMALL/ LARGE BOWEL

20
Q

WHAT IS ILEUS

A

TEMPORARY SLOWING OF DIGESTIVE TRACT MOTILITY > leading to blockage + build up of digestive tract

21
Q

ACUTE MESENTERIC ISCHEMIA

A

constant + severe decrease of blood flow to small intestine due to obstruction in mesenteric artery

22
Q

MESENTERIC ARTERY

A

ARTERY PROVIDING OXYGEN + NUTRIENTS TO INTESTINES

BRANCHE FROM ABDOMINAL AORTA

23
Q

PHYSIOLOGICAL MECHANISMS LEADING TO ACUTE MESENTERIC ISCHEMIA

A
  1. ARTERIAL EMBOLUS
  2. ARTERIAL THROMBOSIS
  3. VASOSPASM
  4. VENOUS THROMBOSIS
24
Q

MC CAUSE OF ACUTE MESENTERIC ISCHEMIA

A

EMBOLUS

50% OF CASES

25
Q

WHICH BOWEL OBSTRUCTION CAUSE RAPID CHANGE IN BOWEL WALL?

A

CLOSED LOOP OBSTRUCTION

26
Q

MC CAUSE FOR LARGE BOWEL OBSTRUCTION

A

CARCINOMA

colon carcinoma

27
Q

LEADING DISORDER IN STRANGULATION OBSTRUCTION

A

BLOOD FLOW OF AFFECTED LOOP IS COMPROMISED

28
Q

EXCESSIVE VOMITING IN SMALL BOWEL OBSTRUCTION LEADS TO?

A

HYPOKALEMIA
vomiting causes > rise in bicarbonate ions due to large loss of gastric acid
vomiting > hypovolemia
> so body will try to eliminate high bicarbonate levels
> increased K secretion in urinary

29
Q

WHAT IS THE TYPE OF PAIN FOR STRANGULATION OBSTRUCTION?

A

CONSTANT + SEVERE PAIN

30
Q

FECULENT TYPE OF EMESIS (VOMIT) IN CASE OF BOWEL OBSTRUCTION?

A

MISERERE

31
Q

IMAGING METHOD FOR BOWEL OBSTRUCTION?

A

PLANE ABDOMINAL X RAY

32
Q

COMMON SITE FOR VOLVULUS?

A

SIGMOID COLON > end part of colon just before rectum

33
Q

TYPICAL X RAY FINDING IN BOWEL OBSTRUCTION?

A

AIR FLUID LEVELS

34
Q

MOST AFFECTED VESSEL IN MESENTERIC EMBOLUS?

A

SUPERIOR MESENTERIC ARTERY

35
Q

MC CAUSE FOR MESENTERIC THROMBOSIS?

A

ARTHEROSCLEROSIS

36
Q

TYPE OF PAIN IN LARGE BOWEL OBSTRUCTION?

A

DULL + CRAMPY PAIN

37
Q

OTHER SYMPTOMS OF LARGE BOWEL OBSTRUCTION?

A

FAILURE TO PASS STOOL

FLATUS - gas in stomach/ intestines

38
Q

OTHER SYMPS OF SMALL BOWEL OBSTRUCTION?

A

NAUSEA + VOMITING

SURGICAL DISEASES (13 decks)

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