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Intestinal Obstruction

This document discusses intestinal obstruction, its causes, symptoms, diagnosis and treatment. It notes that intestinal strangulation usually results from mechanical obstruction, adhesions or bands. Common symptoms include abdominal pain, vomiting, constipation and distension. Diagnostic tests may include blood tests, imaging and endoscopy. Treatment involves rehydration, antibiotics, decompressing the bowel, and exploratory laparotomy to identify and address the cause of obstruction.

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Nurul Nurnita
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731 views12 pages

Intestinal Obstruction

This document discusses intestinal obstruction, its causes, symptoms, diagnosis and treatment. It notes that intestinal strangulation usually results from mechanical obstruction, adhesions or bands. Common symptoms include abdominal pain, vomiting, constipation and distension. Diagnostic tests may include blood tests, imaging and endoscopy. Treatment involves rehydration, antibiotics, decompressing the bowel, and exploratory laparotomy to identify and address the cause of obstruction.

Uploaded by

Nurul Nurnita
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
  • Intestinal Obstruction Overview: Introduces the types and sites of intestinal obstruction, focusing on neurogenic and mechanical causes.
  • Causes of Intestinal Strangulation: Explores the causes of intestinal strangulation, accompanied by illustrative diagrams depicting different types.
  • Mechanical Obstruction by Age Group: Details common causes of mechanical obstruction across different age groups, from neonates to the elderly.
  • Incidence of Intestinal Obstruction: Discusses the incidence rates and affected bowel regions in intestinal obstructions.
  • Physiologic and Pathologic Derangement: Describes the physiological and pathological derangements associated with intestinal obstruction, including secondary complications.
  • Clinical Manifestations: Lists clinical symptoms and physical examination findings associated with abdominal obstruction.
  • Diagnostic Studies: Outlines diagnostic approaches including laboratory tests, imaging, and specific studies for obstruction.
  • Treatment Approaches: Summarizes the treatment protocol for intestinal obstruction, highlighting key medical interventions.
  • Exploratory Laparotomy Procedure: Details the surgical procedure for exploratory laparotomy, including steps and considerations during surgery.

INTESTINAL OBSTRUCTION SAHARA

NEUROGENIC paralytic MECHANICAL MECHANICAL : - Simplex - Stranggulata Aetilogy: -In the lumen -In the wall -Outside the wall Site : - High - Low Speed of onset : - Acute - Chronic

What Causes Intestinal Strangulation?

Intestinal strangulation (cutting off of the blood supply to the intestine) usually results from one of three causes.

MECHANICAL OBSTRUCTION
Common causes of obtruction at each age group Neonate -Congenital atresia -Volvulus neonatum -Meconeum ileus -Hirschsprungs disease -Imperforate anus -Stranggulated inguinal hernia -Intussuception -Complication of Meckels diverticulum -Hischsprungs diseases

Infant

Young adult Middle age

-Adhesions and bands -Strangulated [Link] -Adhesesion and band -Strangulated [Link] -Strangulated [Link] -Carcinoma colon -Volvulus -Adhesion and bands -Strangulated [Link] -Strangulated [Link] -Carcinoma colon -Volvulus -Impacted faeces

Elderly

Incidence
May occur at any age 70 percent small bowel, 30 percent large bowel

Physiologic and Pathologic Derangement


Fluid and electrolyte disturbances -8 10 L of fluid are secreted -Sequestration within the dilated loop-- hypovolumic shock Bacteriology -Rapid colonisation Pathology -High intra luminar pressure- oedematous-- cyanosis intraperitoneal exudation necrosis perforation--peritonitis

Clinical Manifestations
Abdominal pain is colicky -On Auscultation -borborygmi -metalic sound Vomiting - Consists food and gastric chyme- bile faeculent Absolute constipation Abdominal distension -Inspection distended visible peristalsis and colicky pain Sign - the classic quartet->pain,vomiting,constipation,abd dist Scars-- Adhesion or Band Vital Sign---Pulse - SBP RR Temp-- hypovolumic shock ? Palpation--- palpable mass - DRE

Diagnoctic Studies
Laboratory test--->Fecal Occult Blood Test Sigmoidoscopy X ray examination Plain X ray --- Erect and lying down - routinely Follow-through studies after ingestion of radiopague meal --- gastrografin Barium enema X ray

Treatment
NGT Rehydration Foley bag Catheter Antibiotics Informed concent Exploratory laporotomy

Exploratory Laparotomy
Inspected and palpated the Caecum -Distended--- colon obstruction -Collapsed-- small bowel obstruction Distended SBO - Prevent [Link] -Retrograde milkingby Jones and Matheson(1968) -canula inserted + pursetring suture ? -Enterostomy Distended LBO- Prevent [Link] -canula inserted + pursestring suture -Caecostomy

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