Bowel obstruction Flashcards
causes of small bowel obstruction (NB 75% of bowel obstruction is small bowel)
adhesions (70%, usually due to previous surgery)
hernia
crohn’s
neoplasm
causes of large bowel obstrction
MALIGNANCY volvulus strictures diverticular disease hernia abscess
pain before vomiting vs vomiting before pain
vomiting first = infection
pain first = obstruction
findings on xray
dilated bowel loops +/- fluid levels
findings on CT (increasingly replacing xray)
- distinct transition point where bowel changes from normal to abnormal
- dilated bowel loops proximal to transition point
- bowel wall thickening
when are air fluid levels seen and what are they
seen in complete bowel obstruction
air rises above fluid
what sign is seen in intesussuption
donut sign
target sign
pincer sign
sign in volvulus
coffee bean sign - site of obstrcution if opposite concave part of coffee bean)
sign if acute ischaemia
thumb printing of bowel
what sign is seen with contrast enema of colonic voluvlus
bird of prey beak
double contrast enema (air and barium) colon cancer - what sign
apple core sign
what arteries are involved in ischaemic colitis
superior and inferior mesenteric arteries
what causes ischaemic colitis
atherosclerosis
thrombosis
embolism
low flow e.g. hypotension, CHD
symptoms of ischaemic colitis
sudden onset abdo pain
diarrhoea with dark red blood
treatment ischaemic colitis
usually resolves on its own. symptomatic. may need rx if peritonitis or perforation
