Small Bowel Flashcards
(45 cards)
What is the most common cause of a small bowel obstruction?
Adhesions from prior abdominal surgeries
If a patient has a small bowel obstruction and no history of surgeries, what is the likely cause?
Tumor
What is the location of the small bowel obstruction called?
Transition point
What happens to the small bowel proximal and distal to the transition point?
Proximal = Distention
Distal = Narrowing
What are the early signs of a small bowel obstruction?
Episodic pain and increased peristalsis that results in diarrhea
What are the early signs of a small bowel obstruction?
Episodic pain and increased peristalsis that results in diarrhea
What are the late signs of a small bowel obstruction?
Abdominal distention with constant pain, constipation, nausea and vomiting
What are the late signs of a small bowel obstruction?
Abdominal distention with constant pain, constipation, nausea and vomiting
What will be seen on KUB X-ray with a small bowel obstruction?
Air-Fluid levels
Once you have obtained a KUB X-ray for a small bowel obstruction, a CT with/without what type of contrast should be obtained?
CT with IV contrast
What is the treatment for a small bowel obstruction without perforation or other complications?
- NG tube with suction to decompress the proximal bowel distention
- NPO, IVF
- Ambulation
What causes an Indirect Inguinal Hernia?
Failure of processus vaginalis to fuse in males
Where do Indirect Inguinal hernias occur in relation to the inguinal ligament and epigastric vessels?
- Superior to inguinal ligament
- Lateral to epigastric vessels
Where do Indirect Inguinal hernias herniate into?
Into the deep ring/spermatic cord/scrotum
When do Direct Inguinal hernias occur?
In adult males who are straining
Where do Direct Inguinal hernias occur in relation to the inguinal ligament and epigastric vessels?
- Superior to inguinal ligament
- Medial to epigastric vessels
Femoral hernias occur commonly in _____. Where are they in relation to the inguinal ligament?
Females
- Inferior to inguinal ligament
Do Umbilical hernias need corrected in neonates?
Not usually until after 2 years old if they persist
Reducible hernia
Able to push the bowel back in
Incarcerated hernia
Unable to push the bowel back in
Strangulated hernia
Ischemia of the bowel is actively occurring
+ pain, overlying skin discoloration too
What are the signs of a Strangulated hernia? What should be done?
Pain + overlying skin discoloration
–> Emergent surgery
What causes Chronic Mesenteric Ischemia?
Atherosclerosis/stenosis of the Superior Mesenteric A.
Describe how Chronic Mesenteric Ischemia is similar to cardiac angina
With stenosis in a heart vessel, there will be pain with increased blood/oxygen demand only
– The same will occur with chronic mesenteric ischemia except that the increased demand occurs after eating in order for digestion to occur
