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Bowel (intestinal) obstruction (Causes (• Mural or extraluminal., • …
Bowel (intestinal) obstruction
Definition
Intestinal obstruction is a blockage of the intestines evidenced by partial or complete impairment to the forward flow of intestinal contents.
Pathophysiology
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Each day the small intestine secretes six to eight litres of fluid rich in electrolytes.
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Most of this fluid is reabsorbed before the chyme reaches the caecum.
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Some of the fluid is lost in the stool.
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When an obstruction occurs, an imbalance between secretion and absorption develops.
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Intestinal fluid, contents and gas accumulate above the obstruction.
Causes
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Mural or extraluminal.
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Intralumen , such as worms, undigested food
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Tumours
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increased peristalsis
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Hernia
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Volvulus
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Stenosis or strictures
Clinical manifestation
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Pain.
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Discomfort
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Nausea and vomiting abdominal distension.
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This is a common manifestation in intestinal obstruction
.
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Severe constipation
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Dehydration
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Temperature rarely rises above 37.8 °C
Diagnostic studies
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Abdominal X-ray
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Barium swallow
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Sigmoidoscopy
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Colonoscopy
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Blood tests
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Biopsy
Medical management
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Relieve the obstruction
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Minimise pain and discomfort
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Restore normal fluid and electrolyte status.
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Sigmoidoscopy to relieve a sigmoid volvulus
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A barium swallow may relieve intussusception
Surgical management
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Resection of the obstructed segment of bowel
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an end-to-end anastomosis
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Colectomy
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Colostomy
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ileostomy