Presentation, diagnosis and management of bowel obstruction Flashcards Preview

Gastro > Presentation, diagnosis and management of bowel obstruction > Flashcards

Flashcards in Presentation, diagnosis and management of bowel obstruction Deck (25):
1

What will happen to the GI tract proximal to the obstruction

Dilates

2

Describe the presentation of a small bowel obstruction

Acute presentation
Hours of onset
Large volumes vomited

3

What are the presentation of a distal small bowel / large bowel obstruction

Colicky abdominal pain and distension
Vomiting (possibly faeculent)

4

Describe the vomit of a gastric outlet obstruction

Semi-digested food eaten a day or two previously - no bile

5

Describe the vomit of an upper small bowel obstruction

Copious bile-stained fluid

6

Describe the vomit of a more distal obstruction

Thicker
brown
foul smelling
Faeculent

7

What causes colicky pain

Peristalsis attempts to overcome the obstruction

8

What is absolute constipation

Neither faeces of flatus is passed rectally

9

What are signs of incomplete obstruction

Vomiting may be intermittent
Bowel habit erratic

10

Gradual hypertrophy of the muscle of the bowel wall proximally is a sign of what

Chronic incomplete obstruction

11

What are some clinical signs of intestinal obstruction

Bowel sounds are high pitched and tinking

12

What investigations should be done ofr a suspected bowel obstruction

AXR
CT

13

How do we manage an intestinal obstruction

NBM
Insert IV cannula and send blood
Resuscitate with IV fluids, replacing electrolyte losses
Pass an NG tube to decompress the stomach

14

What are some mechanical causes of bowel obstruction

Adhesions or bands
Internal hernia
Volvuus
Tumour
Inflammatory strictures

15

What is the most common cause of large bowel obstruction

Cancer

16

What is a volvulus

A mobile ioop of bowel rotates causing obstruction at its neck

17

What 2 diseases can cause inflammatory strictures?

Crohn's disease
Diverticular disease

18

What are 4 types of bolus obstruction

Food bolus
Impacted faeces
Impacted gallstone ileus
Trichobezoar

19

What is an intussusception

A segment of bowel wall becomes telescoped into the segment distal to it

20

What is a bowel strangulation

A segment of bowel becomes trapped

21

What will happen if strangulation is not relieved

It will pregress to infarction and perforation

22

What are 2 types of adynamic bowel obstruction

Parlytic ilesu
Pseudo-obstruction

23

What is the treatment for paralytic ileus

Drip and suck while awaiting restoration of peristalsis

24

What is pseudo-obstruction syndrome

Acute dilatation of the colon in the absence of colonic obstruction in acutely unwell patients

25

What is the management for a patient with pseudo-obstruction syndrome

Conservative management as the patient gets over the association (e.g. pneumonia or the spinal fracture heals

Decks in Gastro Class (67):