Intestinal Obstruction

Question 1

Define intestinal obstruction

Answer 1

Obstruction of the normal movement of bowel contents.

Classification:
• Large or Small Bowel
• Partial or Complete Obstruction
• Simple, Closed Loop or Strangulated
- Simple: One obstruction point. No vascular
- Closed Loop: Obstruction at 2 points forming a loop of grossly distended bowel at risk of perforation.
- Strangulated: Blood supply is compromised; the pain is sharper, more constant and more localised. There are often signs of mesenteric ischaemia and peritonism.
• Mechanical and Functional
- Mechanical: adhesion (fibrous growth blocking), obstruction, Intersusception (one part into the other), Hernia
- Adhesion – post surgery, Obstrucion – colon cancer, INT – rare in adults – in the ileocaecal valve,
- You can get pseudoblockages such as herschprung disease

Question 2

What are the causes/risk factors of intestinal obstruction?

Answer 2

Small Bowel Obstruction:
Adhesions (Post-op) (60%)

Hernias (20%)

Neoplasms

Crohn’s Strictures

Foreign Bodies

Ileus

Intussusception: A process in which a segment of intestine invaginates into the adjoining intestinal lumen, causing bowel obstruction.

Large Bowel Obstruction:

Colonic Cancer

Constipation

Diverticular Disease

Volvulus –caecal and sigmoid

Crohn’s Strictures

Foreign Bodies

TB (in the developing world).