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Metabolism: Small Bowel Obstruction - Coggle Diagram
Metabolism: Small Bowel Obstruction
Complications
Peritonitis
Aspiration
Abscess death
Sepsis
Death
Compartment syndrome
GI ischemia - necrosis
Signs and Symptoms
Mucus and blood mixed stools
Flatus and loose stools early
Abdominal distension - firm abdomen
Foul discolored emesis
Hernia
Tachycardia - hypovolemia
Hypovolemia and F and E deficits
Peristalsis
Fever
Obstipation
Severe constipation
Borborygmus
Audible and high pitched peristalsis
Severe pain - infants knee to chest
Risk Factors
Prior abdominal or pelvic surgery or complications
Abdominal wall/groin hernia
Intestinal inflammation
History/increased risk of hernia
Prior radiation
Foreign body ingestion
Collaborative Treatments
Aggressive fluid resuscitation
Correct F/E imbalances
Analgesics/antiemetics/Antibiotics
Monitor ABC's
Surgical measures/interventions
NPO
NG Tube
Pathophysiology
An obstruction with the small intestine leads to proximal dilatation, which occurs due to an accumulation of GI secretions and swallowed air.
The dilatation caused by the SBO leads to an increase in cell secretory activity increasing in fluid secretions and accumulation.
The intestines respond with increased peristalsis to rid of the SBO and an increase amount of flatus and liquid stools follow - early stage.
The accumulation of pressure furthers distension and compression of mucosal lymphatics.
The massive hydrostatic pressure leads to contents being driven out of the cells, and the increase in pressure among the capillary beds leads to third spacing (fluids, electrolytes, and proteins).
The lumen is consistently increasing in size while the body is not receiving the fluid, electrolytes, and proteins due to the decrease of absorption in the vascular space. Hypovolemia occurs due to the consistent loss of fluids which leads to shock.
Labs
X-ray
CT scan
Labs
Creatinine and BUN
Serum electrolytes
CBC