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Metabolism: Small Bowel Obstruction - Coggle Diagram
Metabolism: Small Bowel Obstruction
Pathophysiology
Physical obstruction (mechanical) or Non-mechanical > paralytic ileus (commonly abdominal surgery) impede cephlacaudal movement in the GI tract
Increase in GI secretions and air swallowed
Flatus and frequent loose stools early on
Intestines dilate proximal to the block
Abdominal distention from increase pressure in GI lumen, pressure also forces 3rd spacing (fluids/electrolytes/and proteins)
Increases cellular secretions and peristalsis
Decrease intravascular fluid (hypovolemia/dehydration)
Can lead to hypovolemic shock
Symptoms
mucous in stool
F/E deficits
Abdominal pain, constant is normally paralytic ileus
Firm abdomen
Absent/hypoactive bowel sounds (paralytic ileus)
Hypovolemia
Abdomen distention
Emesis
Diarrhea and flatus eraly
Obstipation
Mechanical
Infants knee-chest and mucus/blood mixed stools
Colicky pain
Borborygmus
Fever and tachycardia late symptom
Complications
Infection/sepsis -
Peritonitis
(rigid/ board-like abdomen, intense pain)!!!
Compartment syndrome > necrosis
GI Ischemia
Perforation
Aspiration
Abscesses
Risk factors
Age (infant and elderly)
Impacted stool
Narcotic usage
Post-op
Diagnostics and Labs
BUN and creatinine
CT scan
electrolytes
CBC
Abdominal xray
Ultrasound
Treatment
Fluid resuscitation
NG tube - decompress bowel
correct F/E imbalances
Antiemetics,analgesia,antibiotics
Monitors ABCs
NPO
Surgery
Causes
Post-op adhesion
Intussusception (telescoping bowel segments - common pediatric)
Impacted stool
Tumors (more for LBO)
Hernias
Volvulus (twisted intestine)
Paralytic ileus
Electrolyte imbalance (low K+)
Intestinal ischemia
Intestine infection
Some meds (narcotics esp.)
Post abdomenal surgery