3-Intestinal Obstruction

Question 1

Why cant the intralumenal tumor cant pass to the extralumenal area?

Answer 1

Bcz the colon still has living cells, unless it is ischemic and the cells die

Question 2

Strangulated obstructions

Answer 2

Disruption of the blood circulation

Question 3

Closed loop obstruction

Answer 3

Volvulus

Question 4

simple obstruction

Answer 4

Presence of obstacle in the transmission of the contents of the intestine *without a problem in blood circulation

Question 5

Which one is not an extraluminal mechanical obstruction ?

Question 6

What are examples of extraluminal mechanical obstruction?

Answer 6

Adhesion
Hernia
Neoplastic tm
Small bowel and colon volvulus
Superior mesenteric artery syndrome

Question 7

Hernia?

Answer 7

Defect in the fascia allow for the intestines to pass

Question 8

What is superior mesenteric artery syndrome

Answer 8

Duodenum gets squeezed by two arteries

Question 9

How does tubular organs heal?

Answer 9

With contractions

Question 10

What are the transmural(between wall) mechanical obstruction examples

Answer 10

[CO.S.T.I.]

congenital(stenosis, Meckel’s diverticulum)

traumatic

inflammatory

strictures(restriction)

Question 11

What are the intraluminal mechanical obstruction examples?

Answer 11

Meconium ileus
Invagination
Gallstone ileus (rare)
Feces
Bezoar
Flocculated parasites

Question 12

What is the most imp physical exam for mechanical obstruction?

Answer 12

Mainly Ask about if they fart not if they poop(it may be diarrhea):p

Question 13

during Early period ‘stage’ bowel obstruction, what do you hear on auscultation

Answer 13

Metalic sounds

Question 14

Late period bowel sounds

Answer 14

No sounds

Question 15

***Which is the electrolyte that is most lost during vomiting?

Answer 15

HCl
And later loss of potassium bcz the kidney holds on the H+ and secretes away potassium; hypochloremia+ hypokalemia+ metabolic alkalosis

Question 16

Colonic obstruction causes perforation in the ……

Answer 16

Cecum

Question 17

Proximal dilation of colon

Answer 17

Causes distention

Question 18

Ileocecal part u wont see any

Answer 18

Diarrhea…?

Question 19

When do u see coffee bean sign under radiograph?

Answer 19

In volvulus

Question 20

Treatment for colonic obstruction

Answer 20

-For dehydration: isotonic or ringer lactate iv
-After checking for urine output,Potassium must be given
-Nasogastric tube insertion
-Broad spectrum antibiotics

Question 21

In which type of intestinal obstruction do u see ischemia

Answer 21

In strangulated obstruction of the colon

Question 22

Unless it is adhesion obstruction, you always need ….. as treatment

Answer 22

Emergent surgery such as in :S.C.C.S
-strangulated obstruction
-closed loop obstruction
-colonic obstruction
-simple mechanical obstruction

Question 23

Does adhesions of the intestines reoccur

Answer 23

Yes it may occur again,

Question 24

No colic style abdominal pain and bowel sounds are reduced in which are of the GIS obstruction?

Answer 24

Ileus obstruction

Question 25

Hypothyroidism, spinal cord injury,electrolyte disorders,pancreatitis,Surgical stress, retroperitoneal hematoma, may be a cause of obstruction in …..

Answer 25

Ileus

Question 26

Which one is revesible obstruction

Answer 26

Ileus

Question 27

Which one is irrevesible obstruction

Answer 27

Intestinal psodoobstruction

Question 28

when do you hear metallic sounds on auscultation

Answer 28

during early stage of bowel obstruction

Question 29

when does dehydration due to vomiting, hypochloremia, hypokalemia, and metabolic alkalosis are seen?

Answer 29

proximal obstruction

Question 30

symptoms of intestinal obstruction

Answer 30

abdominal pain colic style nausea vomiting distension gas-fecal inability to pass

Question 31

what is the tx for adhesion?

Answer 31

NG tube conservative tx can be extended up to 24-48 hrs

Question 32

what is the benefit of NG tube?

Answer 32

reduce risk of aspiration reduces tension(to improve blood circulation) in obstruction due to adhesion

Question 33

what are the non mechanical intestinal obstruction reasons?

Answer 33

ileus pseudo obstruction

Question 34

is ileus treatable?

Answer 34

yes; by giving NG if vomiting or distension and fluid-electrolyte therapy and TPN

Question 35

which type of intestinal pseudoobstruction occurs in intestinal smooth muscle, myenteric plexus, extraintestinal nervous system?

Answer 35

intestinal pseudo-obstruction

Question 36

definitive dx of intestinal pseudo-obstruction?

Answer 36

laparotomy and full thickness biopsy of intestine

Question 37

which layer of the intestine is affected in the intestinal pseudo-obstruction

Answer 37

muscularis propria; myenteric and miessner plexus