Bowel obstruction

Question 1

Which is more common small or large?

Answer 1

Small

Question 2

What is third spacing

Answer 2

The gastrointestinal tract secretes fluid that is later absorbed in the colon. When there is an obstruction, and fluid cannot reach the colon, it cannot be reabsorbed. As a result, there is fluid loss from the intravascular space into the gastrointestinal tract. This leads to hypovolaemia and shock.

Question 3

Causes

Answer 3

Adhesions
Hernias
Malignancy
Volvulus
Diverticular disease
Strictures
Intussusception

Question 4

What is a closed loop obstruction? when does it tend to happen

Answer 4

2 points of obstruction
Can happen in large bowel with a competent ileocaecal valve

Question 5

Features of bowel obstruction

Answer 5

Vomiting
Abdo distension
Diffuse abdo pain
Constipation, lack of flatulence
Tinkling bowel sounds

Question 6

What are the upper limits of normal diameter of bowel

Answer 6

small bowel 3 cm
colon 6cm
caecum 9cm

Question 7

What are valvulue conniventes

Answer 7

mucosal folds that form lines extending the full width of the bowel. These are seen on an abdominal x-ray as lines across the entire width of the bowel.
Seen in SMALL BOWEL O

Question 8

What are haustra

Answer 8

Form lines that dont extend the full width of the bowel in large bowel obstruction

Question 9

What may be seen on VBG

Answer 9

Metabolic alkalosis due to vomiting stomach acid
Raised lactate due to bowel ischaemia

Question 10

Investigations

Answer 10

Abdo XR
Erect CXR
Contract CT abdo

Question 11

When is it managed conservatively?

Answer 11

Adhesions
Volvulus
AND stable

Question 12

Definitive management

Answer 12

Surgery
Adhesiolysis
Hernia repair
Emergency resection of tumour
Stents