03.06 Obstruction in Adults

Question 1

Most common site for unqualified intestinal obstruction

Answer 1

Small bowel

Question 2

Second most common site for unqualified intestinal obstruction

Answer 2

Left side of the colon

Question 3

Most common cause of obstruction

Answer 3

Post-operative adhesions

Question 4

Second most common cause of obstruction

Answer 4

Hernia

Question 5

Most common cause of intraluminal obstruction

Answer 5

Tumor

Question 6

Intraluminal obstruction may also be caused by constrictions

Part of the stomach sliding up to the esophageal hiatus due to intra-abdominal pressure and a negative thoracic pressure

Answer 6

Hiatal hernia

Question 7

Caused by a defect in the mesentery segments of the bowel, insinuating itself into the different false internal areas

Answer 7

Volvulus

Question 8

Fecal material may be lodged in the weakened colonic wall causing _____

Answer 8

Diverticulitis

Question 9

Congenital problem
Failure of de-rotation, the stomach and duodenum pulls the cecum through adhesive band, preventing it from going to the proper place and causing obstruction

Answer 9

Malrotation

Question 10

Single bubble sign in chest x-ray

Answer 10

Hypertrophied pyloric ring

Question 11

Segment of the bowel telescopes into another segment

Answer 11

Intussusception

Question 12

Clinical condition of GIT where normal transmission is impeded so that products of digestion are prevented from exiting.
Urgent management is needed

Answer 12

Intestinal obstruction

Question 13

Adhesion is proximal to the ligament of Treitz, there is ____

Answer 13

No abdominal distention

Question 14

If the IO is distal to the D2 segment of the duodenum, there is ____ vomitus

Answer 14

Bilious

Question 15

If the IO is proximal to the D2 segment of the duodenum, it is _____

Answer 15

Nonbilious

Question 16

Most common conditions of mechanical IO

Answer 16

Adhesions
Malignancy
Hernia

Question 17

Etiologies can range from derangement of sympathetic and parasympathetic control of the GIT, surgical trauma, and electrolyte imbalance

Answer 17

Functional IO

Question 18

Distention of colon due to obstruction usually caused by defect in sympathetic nerve supply

Answer 18

Ogilvie’s syndrome

Question 19

What type of loop obstructions are surgical emergencies

Answer 19

Closed loop

Question 20

Distal tumor blocking and a competent ileocecal valve

Answer 20

Closed loop

Question 21

Proximal bowel dilatation alters the:

Answer 21

GI motility
Mucosal lining
Absorptive capacity of the intestines

Question 22

Distention proximal to obstruction is produced by

Answer 22

Gas

Fluid

Question 23

Most important reference in terms of level of obstruction

Answer 23

Ligament of Treitz

Question 24

Melena is black, sticky stool associated with bleeding in ____
Bezoar
Hyponatremia and hypochloremia

Answer 24

Proximal upper gut

Question 25

Succus entericus Fecaloid if obstruction is distal Tenderness due to marked distention Hypokalemia and hyponatremia

Answer 25

Distal lower gut

Question 26

Dx of IO

Answer 26

Air fluid levels Ileus Endoscopy (intraluminal obstruction)

Question 27

Associated conditions of IO

Answer 27

Dehydration, electrolyte, malnutrition and sepsis

Question 28

Sequelae of IO

Answer 28

Necrosis Rupture/perforation Peritonitis Sepsis