Bowel Obstruction

Question 1

List 2 common causes of Bowel Obstruction in Adults and Children

Answer 1

Children;

• Intestinal atresia
• Intussusception

Adults;

• Adhesions
• Incarcerated hernias

Question 2

What is Intussusception?

What is the suspected cause?

Answer 2

When one part of bowel ‘prolapses’ into another part (Can also prolapse out of rectum)

A ‘Lead point’, a mass that precipitates the prolapsing action

(E.g Meckel’s diverticulum, Enlarged lymph node)

Question 3

What are 2 complications of Intussusception?

What are 3 symptoms?

What are 2 treatments?

Answer 3

Complications;

• Oedema
• Infarction

Symptoms;

• Haematoochezia
• Ab pain
• Vomiting

Treatment;

• Air enema
• Surgery

Question 4

Small bowel obstruction can be caused by Intra-abdominal adhesions.

Suggest 2 causes of these adhesions

List 2 other causes of SI obstruction

Answer 4

• Abdominal surgeries
• Damage to mesothelium
• Crohn’s (causes narrowing)
• Incarcerated hernias

Question 5

Large bowel obstruction is typically in the older generation

List 3 common causes

Answer 5

• Colon cancer
• Diverticular disease
• Vovulus (Sigmoid, Caecal)

Question 6

List 4 symptoms of large bowel obstruction

How does symptom onset differ if due to Cancer or Volvulus?

Answer 6

• Change in bowel habit
• Ab distension
• Crampy ab pain
• Nausea + Vomiting
• Gradually with cancer, Abruptly with Volvulus (Part of bowel twists around itself and mesentery)

Question 7

What are the 2 most common places for a Volvulus to occur?

Answer 7

• Sigmoid Colon (60%)

- Caecum (If here, can lead to SI and LI obstruction)

Question 8

Suggest 1 cause of a Sigmoid Volvulus

Answer 8

An overloaded sigmoid colon (constipation or high fibre diets)