Bowel Obstruction Flashcards

(36 cards)

1
Q

what causes the bowel proximal to obstruction to become dilated?

A

air and fluid

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2
Q

what is disrupted in bowel obstruction?

A

peristalsis

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3
Q

what determines how early vomiting develops in obstruction?

A

how proximal the obstruction is

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4
Q

why can vomiting occur in obstruction if nothing is eaten?

A

GI secretions are continually produced and can be vomited

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5
Q

what type of obstruction does vomiting semi-digested food with no bile suggest?

A

gastric outlet obstruction

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6
Q

what type of obstruction does bile stained vomit suggest?

A

upper small bowel obstruction

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7
Q

what type of obstruction does thicker, brown and foul smelling vomit suggest?

A

a more distal obstruction (distal small bowel, large bowel)

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8
Q

name the four main symptoms of intestinal obstruction

A

vomiting
pain
constipation
distension

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9
Q

what causes pain in bowel obstruction?

A

distension of the bowel

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10
Q

describe the pain that presents with bowel obstruction

A

intermittent episodes of colicky pain

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11
Q

what type of constipation is associated with bowel obstruction?

A

absolute constipation

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12
Q

what does absolute constipation mean?

A

neither faces or flatus is passed rectally

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13
Q

what type of obstruction causes more gradual onset of symptoms and why?

A

large bowel obstruction

due to its large capacity and ability to absorb

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14
Q

what is incomplete obstruction?

A

when the bowel is only partially obstructed

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15
Q

what does chronic incomplete obstruction result in?

A

gradual hypertrophy of the muscle of the bowel wall proximal to the obstruction

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16
Q

what does obstruction with abdominal tenderness indicate?

A

bowel strangulation

17
Q

in normal bowel obstruction, what is lacking on examination?

A

abdominal tenderness

18
Q

what may be able to feel on palpation in bowel obstruction?

A

the obstructive mass

19
Q

what is heard upon abdominal percussion in bowel obstruction?

A

the centre of the abdomen tends to be resonant due to gaseous distension

20
Q

why does the groin need to be examined in bowel obstruction?

A

for an obstructing hernia

21
Q

what do bowel sounds sound like in bowel obstruction?

A

high-pitched and tinkling

22
Q

what is the most useful first line investigation for bowel obstruction?

23
Q

what scan can be used to confirm diagnosis of bowel obstruction and look for its cause?

24
Q

what diet should a patient with bowel obstruction be on?

25
what is involved in the initial management of intestinal obstruction?
IV cannula and send blood IV fluids NG tube
26
why is an NG tube inserted in intestinal obstruction?
to decompress the stomach
27
name seven mechanical things that can cause bowel obstruction
``` adhesions incarcerated hernia volvulus tumour strictures bolus obstruction intussusception ```
28
name three things that can cause adhesions
congenital abdominal surgery peritonitis
29
what is a volvulus?
a mobile loop of the bowel rotating around itself, causing obstruction
30
what two diseases can cause inflammatory strictures?
crohn's | diverticular disease
31
what are obstructions caused by strictures typically like?
incomplete
32
what happens in intussusception?
a segment of bowel wall becomes telescoped into the segment distal to it
33
what is paralytic ileus?
disruption of the normal propulsive activity of the GI tract due to failure of peristalsis
34
name three risk factors for paralytic ileus
recent GI surgery inflammation diabetic ketoacidosis
35
how is paralytic ileus treated?
"drip and suck" while waiting for restoration of peristalsis
36
what is pseudo-obstruction?
acute dilation of the colon in the absence of colonic obstruction in acutely unwell patients