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Small Bowel Obstruction (Image (Dilated loops of bowel ≥3cm in width,…

- - - - Impacted faeces
      - FB
      - Gallstone
    - - Benign stricture
      - Malignant stricture
      - Congenital atresia
    - - Pancreatic pseudocyst
      - Abscess
      - Congenital bands
    - - Post-op
      - Peritonitis
      - Pancreatitis / local inflammation
      - Poisons: e.g. TCAs
      - Metabolic: ↓K, ↓Na, ↓Mg, uraemia
      - Mesenteric ischaemia
- - - - Significant 3rd space losses
      - On-going requirements
      - Electrolyte disturbances
      - Catheterise: aim for 0.5ml/kg/hr
    - - Decompress upper GIT
      - Stops vomiting
      - Prevents aspiration
  - - - Failure of conservative Mx: up to 72hrs
      - Development of sepsis
      - Peritonitis
      - Evidence of strangulation
- - - - Closed loop obstruction
      - Obstructing neoplasm
      - Strangulation or perforation
      - Failure of conservative Mx
- - - - Carcinoma: 60%
      - Diverticular stricture: 20%
      - Volvulus
  - - - Impacted faeces
      - FB
    - - Benign stricture
      - Malignant stricture
    - - Adhesions
      - Hernia
      - Abscess
      - Haematoma
      - Tumour: e.g. ovarian
    - - Pseudo-obstruction: Ogilvie’s syndrome
      - Metabolic: ↓K, ↓Na, ↓Mg, uraemia
      - Poisons: e.g. TCAs
      - Mesenteric ischaemia
- - - - Caecostomy
      - Right hemi w/ primary ileocolic anastomosis