Bowel Obstruction

Question 1

What are common causes?

Answer 1

SBO- adhesions, hernias, strictures
LBO- colorectal caner, volvulus, diverticular disease

Question 2

What are clinical features of SBO?

Answer 2

Diffuse abdo pain
N&V
Constipation and lack of flatulence
Tinkling bowel sounds

Question 3

What are investigations for SBO?

Answer 3

AXR
- Small bowel >3cm
- central location
- valvulae conniventes

CT= gold standard

Question 4

What are clinical features of LBO?

Answer 4

Constipation and lack of flatulence
Abdo distension
May get nausea and vomiting

Question 5

What are investigations for LBO?

Answer 5

AXR
-Large bowel >6cm
-Caecum >9cm
- peripheral loops
-haustra

CT AP gold standard

Question 6

What is the management?

Answer 6

Initial
-NG tube for drip and sick (esp SBO)
- IV fluids and electrolyte correction

Conservative management without signs of peritonitis or ischaemia

Surgical if signs of intestinal ischaemia, perforation or closed loop obstruction