| ID | 405 |
|---|---|
| Name | INTESTINAL OBSTRUCTION |
| Cause | Causes of intestinal obstruction may include fibrous bands of tissue (adhesions) in the abdomen that form after surgery; hernias; colon cancer; certain medications; or strictures from an inflamed intestine caused by certain conditions, such as Crohn's disease or diverticulitis. |
| Signs Symptoms | Signs and symptoms of intestinal obstruction include: Crampy abdominal pain that comes and goes. Loss of appetite. Constipation. Vomiting. Inability to have a bowel movement or pass gas. Swelling of the abdomen |
| Diagnosis | To confirm a diagnosis of intestinal obstruction, your doctor may recommend an abdominal X-ray. However, some intestinal obstructions can't be seen using standard X-rays. Computerized tomography (CT). A CT scan combines a series of X-ray images taken from different angles to produce cross-sectional images |
| Investigations | Tests and procedures used to diagnose intestinal obstruction include: Physical exam. Your doctor will ask about your medical history and your symptoms. ... X-ray. To confirm a diagnosis of intestinal obstruction, your doctor may recommend an abdominal X-ray. ... Computerized tomography (CT). ... Ultrasound. ... Air or barium enema. |
| Management | Management of uncomplicated obstructions includes fluid resuscitation with correction of metabolic derangements, intestinal decompression, and bowel rest. Evidence of vascular compromise or perforation, or failure to resolve with adequate bowel decompression is an indication for surgical interventio |
| Introduction | Many congenital and perinatal anomalies of the gastro-intestinal tract may be responsible for partial or complete obstruction. Acquired intestinal obstruction usually caused by paralytic ileus, incarcerated inguinal hernia, intussusception, masses of round worm etc. |
| History | |
| Etiology | Etiology: A. Congenital- 1. Congenital hypertrophic pyloric stenosis. 2. Duodenal atresia or stenosis. 3. Jejunal or ileal atresia or stenosis. 4. Malrotation with or without volvulus neona-torum 5. Meconium ileus. 6. Hirschsprung disease (aganglionic megacolon) 7. Imperforate anus. 8. Duplications and diverticula. B. Acquired - 1. Paralytic ileus caused by gastroenteritis, peritonitis, pneumonia. 2. Incarcerated inguinal hernia. 3. Intussusception 4. Post operative adhesions. 5. Chronic peritonitis. 6. Inspissated meconium. 7. Tumours of the bowel including mesenteric cysts. 8. Masses of round worms. |
| Clinical Features | Signs and symptoms of intestinal obstruction include: Crampy abdominal pain that comes and goes. Loss of appetite. Constipation. Vomiting. Inability to have a bowel movement or pass gas. Swelling of the abdomen. |
| Preventions | To prevent another blockage For example, have 5 or 6 small meals throughout the day instead of 2 or 3 large meals. Chew your food very well. Try to chew each bite about 20 times or until it is liquid. Avoid high-fibre foods and raw vegetables and fruits with skins, husks, strings, or seeds |
| Treatment | Treatment for complete obstruction Surgery typically involves removing the obstruction, as well as any section of your intestine that has died or is damaged. Alternatively, your doctor may recommend treating the obstruction with a self-expanding metal stent |
| Complications | Complications of intestinal obstruction include: Pain. Constipation. Loss of appetite. Inability to keep food or fluids down. Fever. Infection. Tear (perforation) of the intestine. Death (rare) |
| Prognosis | What is the prognosis (outlook) for people who have a large bowel obstruction? Most people with large bowel obstructions improve after treatment. Their bowels start to function again. If an obstruction causes a rupture, the condition can be life-threatening |
| Types | The intestinal obstruction can be of two types: complete blockage or partial blockage. Also, you can have a pseudo-obstruction |
| Classification | |
| Observation | |
| Pathology | Pathophysiology of Intestinal Obstruction Ingested fluid and food, digestive secretions, and gas accumulate above the obstruction. The proximal bowel distends, and the distal segment collapses. The normal secretory and absorptive functions of the mucosa are depressed, and the bowel wall becomes edematous and congested |
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