78 Intestinal obstruction

ADYNAMIC OBSTRUCTION Paralytic ileus This may be defined as a state in which there is failure of ...

Acute intestinal obstruction of the newborn Neonatal intestinal obstruction has many potential ca...

Acute intussusception This occurs when one portion of the gut invaginates into an immediately ad...

Bolus obstruction Bolus obstruction in the small bowel may be caused by gall stones, food, tricho...

CHRONIC LARGE BOWEL OBSTRUCTION The symptoms of chronic intestinal obstruction may arise from tw...

CLASSIFICATION Intestinal obstruction may be classified into two types: /uni25CF Dynamic , in whic...

CLINICAL FEATURES OF INTESTINAL OBSTRUCTION Dynamic obstruction The diagnosis of dynamic intesti...

Clinical features of strangulation It is vital to distinguish strangulating from non-strangulatin...

Clinical features of volvulus Volvulus of the small intestine This may be primary or secondary an...

Closed-loop obstruction This occurs when the bowel is obstructed at both the proximal and distal ...

Constipation This may be classified as absolute (i.e. neither faeces nor flatus is passed) or relat...

Distension In the small bowel the degree of distension is dependent on the site of the obstruct...

IMAGING Erect abdominal films are no longer routinely obtained and the radiological diagnosis is b...

Imaging in intussusception A plain abdominal field usually reveals evidence of small or large bow...

Imaging in volvulus /uni25CF In caecal volvulus, radiological abnormalities are iden tifiable in n...

Introduction No content extracted automatically.

Investigation Plain abdominal radiography confirms the presence of large bowel distension. All su...

Learning objectives To understand: The pathophysiology of dynamic and adynamic intestinal • obstr...

Obstruction from enteric strictures Small bowel strictures usually occur secondary to tubercu los...

Other manifestations Dehydration Dehydration is seen most commonly in small bowel obstruc tion be...

PATHOPHYSIOLOGY Irrespective of aetiology or acuteness of onset, in dynamic (mechanical) obstru...

Pain Pain is the first symptom encountered; it occurs suddenly and is usually severe. It is colick...

Postoperative intestinal obstruction Di ff erentiation between persistent paralytic ileus and earl...

Pseudo-obstruction This condition describes an obstruction, usually of the colon, that occurs in...

SPECIAL TYPES OF MECHANICAL INTESTINAL OBSTRUCTION Internal hernia Internal herniation occurs wh...

Supportive management Nasogastric decompression is achieved by the passage of a non-vented (Ryle)...

TREATMENT OF ACUTE INTESTINAL OBSTRUCTION There are three main measures used to treat acute intes...

TREATMENT OF ACUTE LARGE BOWEL OBSTRUCTION Large bowel obstruction is caused by an underlying car...

Treatment of adhesions Initial management is based on intravenous rehydration and nasogastric dec...

Treatment of caecal volvulus At operation the volvulus is frequently found to be ischaemic and ne...

Treatment of intussusception In the infant with ileocolic intussusception, after resuscitation wi...

Treatment of recurrent intestinal obstruction caused by adhesions Several procedures may be consi...

Treatment of sigmoid volvulus Flexible sigmoidoscopy or rigid sigmoidoscopy and insertion of a fla...

Vomiting The more distal the obstruction, the longer the interval between the onset of symptoms ...