# Obstruction

Obstruction

Central colicky abdominal pain is a classic presentation of small bowel obstruction. The central distribution is because of the segmental nerve supply of  the midgut. When the peristaltic waves hit an obstruction, the contractions increase to over come the resistance, producing the colic. The pain reaches a crescendo and then disappears in minutes when the peristaltic wave passes. This is di ff erent from that of biliary colic. When the gallbladder contracts against a stone, pain is relatively insidious in onset and reaches its peak in about half  an hour and then eases o ff . A basal pain persists between the bouts of colic. Pain of  ureteric colic is intense, lasting 1–2 minutes along the line of  the ureter. Summary box 63.6 Colicky abdominal pain /uni25CF /uni25CF /uni25CF 

Pain of ‘small bowel colic’ comes in waves and disappears
completely in minutes when the peristaltic wave ceases
Pain of biliary colic is insidious in onset, reaches the peak in
half an hour or so and does not ease off completely between
spasms
Pain of ureteric colic is intense, lasting 1–2 minutes