large bowel obstruction

Question 1

Radiological abnormalities supporting large bowel obstruction on plain AXR ?

Answer 1

> 7 air fluid level
no air in the rectum
evidence of haustra with significant distention
large bowel ( peripheral VS small bowel ( central )
Small bowel ( valvulae connaventyes )

Question 2

pathological causes of LBO in 75 yr M P/W acute abd pain and distention

Answer 2

1-primary colorectal carcinoma 
2- Diverticular disease   /infection
3- Ischemic colitis with stricture 
4- FB obstruction
5- volvulus ( sigmoid /caecal )

Question 3

List 4 possible complications of acute LBO ?

Answer 3

1- aspiration/vomiting
2- Tachypnoea secondary to pain and acidosis
3- hypotension secondary to third space loss
4- Electrolyte disturbance secondary to fluids shift
5- Acute renal impairment

Question 4

List 3 surgical emergencies in large bowel obstruction

Answer 4

1- ischemic colitis
2- volvulus ( caecal ) difficult to decompress due to caecal valve closure
3=closed loop bowel obstruction ( high grade ischemia )

Question 5

SIzes OF
SB
LB
Caecum

Answer 5

SB max 3 cm
LB max 6 cm
Caecum max 9cm