Bowel obstruction Flashcards
1
Q
What causes small bowel obstruction? (4)
A
Adhesions (common in developed world, due to abdo surgery)
Hernia (common in developing world)
Malignancy
Crohn’s disease
2
Q
What are the clinical presentations of small bowel obstruction? (4)
A
Colicky then diffuse pain, higher in abdomen
Vomiting occurs earlier
Increased bowel sounds
Constipation w no wind occurs LATE
3
Q
What causes large bowel obstruction? (3)
A
US/European adult - colorectal malignancy
African adults - volvulus
Children - anatomical development
4
Q
What are the clinical presentations of large bowel obstruction?
A
Constant abdo pain Abdominal distension Palpable mass (hernia, distended bowel loop or caecum) Late faecal vomiting (incompetent ileocecal valve)
5
Q
How would you investigate bowel obstruction? (5)
A
Abdominal X-ray: gas shadows Examination of hernia orifices DRE FBC CT abdomen (gold standard)
6
Q
What would you find on a DRE in large bowel obstruction? (3)
A
Empty rectum
Hard stools
Blood
7
Q
How would you treat bowel obstructions? (5)
A
Aggressive fluid resuscitation Bowel decompression Analgesia, antiemetic Antibiotics Surgery to remove obstruction
