Small Bowel Obstruction Flashcards
What are the two types of small bowel obstruction?
Partial or Complete
Name some causes of small bowel obstruction?
Adhesions
Hernias
Cancer
Crohn’s
Presentation of small bowel obstruction?
Colicky pain around the umbilicus Vomiting (Foul smelling) Distended abdomen Constipation HIGH PITCHED TINKLING BOWEL SOUNDS
Describe what happens on either side of the obstruction?
The proximal side of the bowel becomes dilated while the distal part of the bowel collapses
What is strangulated obstruction?
This is when the blood supply to the bowel becomes impaired leading to ischamia and gangrene (Only takes 6 hours)
Describe how perforation occurs in small bowel obstruction?
Perforation occurs in the ischaemic section of the bowel
What is done to diagnose small bowel obstruction?
History Examination AXR FBC (Anaemia) U&Es Amylase CRP
If the history and blood tests indicated small bowel obstruction, what is done next?
Laparotomy to make diagnosis
How do you treat small bowel obstruction with NO strangulation?
- IV Fluids
- Nasogastric Suction
- Laparotomy
- Surgery if doesn’t resolve
How do you treat small bowel obstruction with Strangulation?
- Resuscitate
- Early Antibiotics
- Early Surgery
What can strangulation present as?
Sepsis
Shock
Constant Pain
What is paralytic ileus?
Paralysis of the small intestine muscle causes small bowel obstruction (due to bolus of food not being moved along)
Cause of paralytic ileus?
Normally after surgery when there has been excessive handling of the bowel
Symptoms of Paralytic ileus?
Constipation Abdominal Distension Nausea Vomiting NO BOWEL SOUNDS
