Week 6 - Obstruction Flashcards
what is intestinal obstruction
- any situation where there is an impaired movement of the intestinal contents
where does intestinal obstruction commonly occur in? where can it occur in?
- can occur in both large & small intestine
- most commonly in small tho
list 2 causes of intestinal obstruction
- mechanical
2. functional
what is mechanical obstruction of the intestine
- occurs when there is physical obstruction in the intestine
list 8 examples of mechanical obstruction
- tumor
- scar tissue
- adhesions from previous surgery
- diverticular disease
- inguinal hernia
- volvulus
- intussusception
- infarction
what is functional obstruction of the intestineq
-results from neuro impairment or failure of propulsion in the intestine
what is functional obstruction of the intestine often called
- paralytic ileus
list 8 examples of causes of functional obstruction
- peritonitis
- pancreatitis
- crohn’s disease
- ulcerative colitis
- electrolyte abnorm
- mesentric thrombus
- spinal cord injury
- sever medical illness
list 7 symptoms of intestinal obstruction
- borborygmi if mechanical obstruction
- absence of BS if functional
- pain
- distension
- vomiting
- hypovolemic shock
- ischemia/necrosis
describe how mechanical obstruction causes borborygmi
- mechanical obstruction results in audible rumbling sounds as the intestine attempt to push its contents forward
list 7 symptoms of intestinal obstruction
- borborygmi if mechanical obstruction
- absence of BS if functional
- pain
- distension
- vomiting
- decreased BP & hypovolemic shock
- ischemia/necrosis
what does ischemia and necrosis lead to in intestinal obstruction
- causes increased permeability = peritonitis
what does ischemia and necrosis lead to in intestinal obstruction? how?
- peritonitis
- prolonged ischemia causes increased permeability of the wall = intestinal bacteria to enter the blood & peritoneal cavity
what causes severe vomiting in intestinal obstruction? what can this lead to?
- from distension & pain
- can lead to electrolyte imbalance & dehydration
what causes hypovolemic shock in intestinal obstruction
- increased pressure on the wall causes fluid to shift into the intestine = 3rd spacing fluid shift
describe the onset of a small vs large intestinal obstruction
- small = rapid
- large = gradual
describe vomiting in small vs large intestinal obstruction
- small = frequent & copious
- large = late manifestation
describe pain in small vs large intestinal obstruction
- small = colicky, cramplike, intermittent (w peristaltic activity)
- large = low-grade, cramping, abdominal pain
describe bowel movement in small vs large intestinal obstruction
- small = feces for short time
- large = absolute constipation
describe abdominal distension in small vs large intestinal obstruction
- small = dependent on location of obstruction; minimal to greatly increased
- large = greatly increased
what are diverticula
- herniations of the mucosa and submucosa thru the muscularis layer of the colon wall
what part of the colon do diverticular commonly involve
- sigmoid colon
are more people asymptomatic or symptomatic with diverticular disease
- 80% asymptomatic except for constipation and/or diarrhea
occasionally, diverticula may become… (2)
- inflammed
- or bleed
what are diverticula that are inflammed called
- diverticulitis
list 3 risk factors for diverticulosis
- consumption of highly refined foods
- less dietary fiber
- chronic constipation
how do the risk factors for diverticulosis increase the risk?
- increase the pressure within the GI lumen which can cause herniation
low fibre –> constipation –> increased luminal pressure –> muscle hypertrophy –> herniation of mucosa
list manifestations of diverticulosis (4)
- mild abdominal pain
- constipation
- diarrhea
- flatulence
what causes abdominal pain & constipation in diverticulosis
- increased muscle contraction necessary to maintain forward propulsion of feces
how long does pain associated with diverticulosis last? what relives it?
- hours to days
- relived by passing flatus or feces
episodes of constipation, diarrhea, and flatulence in diverticulosis suggest…
- a link to irritable bowel syndrome
list manifestations of diverticulitis (4)
- lower left abdominal pain
- melena or occult blood in stool
- slight fever
- leukocytosis
what can cause inflammation of the diverticula
- fecal stasis
list 4 complications of diverticulitis
- obstruction
- perforation
- abcess formation
- peritonitis
describe the treatment for diverticulosis (3)
- increasing fecal bulk
- encouraging regular defacation
- antibiotics if necessary
what is a polyp
- overgrowth of epithelial cells
what are 2 types of polyps
- hyperplastic
- adenomatous
what are adenomatous polyps
- pre cancerous or cancerous polyp
what are hyperplastic polyps
- benign polyps
describe the diagnostic studies and collaborative care for polyps
- colonscopy
- removal
