bowel obstruction Flashcards

(31 cards)

1
Q

Intussusception

A

segment of the bowel wall becomes telescoped into the segment distal to it

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2
Q

Intussusception stools

A

currant jelly

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3
Q

Intussusception US

A

bullseye appearance

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4
Q

who is Intussusception common in

A

children

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5
Q

what is the most common cause of Intussusception in children

A

lymphoid hyperplasia due to rotavirus

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6
Q

what is the most common cause of Intussusception in adults

A

tumours

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7
Q

who does volvulus normally occur in and what are the clinical features

A

in the elderly in the sigmoid colon

Presents with abdominal pain, distension and constipation

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8
Q

common locations of volvulus in YP

A

caecum

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9
Q

volvulus diagnosis

A

AXR

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10
Q

volvulus treatment

A

flatus tube or surgical resection

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11
Q

causes of small bowel obstruction

A

adhesions

hernias

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12
Q

causes of large bowel obstruction

A

colonic cancer
volvulus
face impaction
diverticular disease

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13
Q

rarer causes of obstruction

A
crohn stricture 
gallstone ileus
intussusception 
TB 
foreign body
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14
Q

CF

A

vomiting
constipation
distension
colicky pain

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15
Q

compare vomiting timing

A

the more proximal the obstruction the earlier it occurs

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16
Q

compare vomiting

A

semi digested food - gastric outlet obstruction
bile stained fluid (green) - upper small bowel obstruction
faeculent (thick, brown, foul smelling) - distal obstruction

17
Q

compare pain

A

more constant in large bowel obstruction

18
Q

compare distension

A

less in small bowel obstruction

19
Q

other CF

A

dehydration

relative lack of abdominal tenderness

20
Q

percussion

A

centre of abdomen resonant often

21
Q

auscultation

A

tinkling and high pitched bowel sounds

22
Q

investigations

A

AXR supine

CT

23
Q

treatment

A

NBM
insert IV cannula and give IV fluids
NG tube to decompress stomach (remove contents)

24
Q

Paralytic ileus

A

absence of normal peristaltic contractions

25
Paralytic ileus CF
similar to obstruction although pain and high pitched bowel sounds less common
26
pseudo obstruction
mechanical GI obstruction but with no causes for obstruction found
27
pseudo obstruction acute is called
Ogilvie's syndrome
28
pseudo obstruction associated with
hip replacement, CABG, spinal anaesthesia, pneumonia - | all associated with frail/elderly patients
29
strangulation pain
sharper and more localised
30
strangulation CF
``` signs of sepsis acutely unwell shock multisystem organ failure death ```
31
strangulation treatment
urgent surgery