What radiographic findings are typical of intestinal obstruction?

The key radiographic signs that allow distinction between a high-grade SBO and a low-grade obstruction are the presence of small bowel distention, with maximal dilated loops averaging 36 mm in diameter and exceeding 50% of the caliber of the largest visible colon loop as well as a 2.5 times increase in the number of …

What abnormal findings might be assessed in a patient with an intestinal obstruction?

The patient with a small bowel obstruction will usually present with abdominal pain, abdominal distension, vomiting, and inability to pass flatus. In a proximal obstruction, nausea and vomiting are more prevalent.

What are the four hallmark clinical manifestations of a bowel obstruction?

Clinical findings of SBO include crampy abdominal pain, distention, vomiting, and high-pitched or absent bowel sounds.

How do you assess a patient with a bowel obstruction?

The doctor may suspect intestinal obstruction if your abdomen is swollen or tender or if there’s a lump in your abdomen. He or she may listen for bowel sounds with a stethoscope. X-ray. To confirm a diagnosis of intestinal obstruction, your doctor may recommend an abdominal X-ray.

What body systems are affected by small bowel obstruction?

Small bowel obstruction is a partial or complete blockage of the small intestine, which is a part of the digestive system. Small bowel obstruction can be caused by many things, including adhesions, hernia and inflammatory bowel disorders.

What are the classification of intestinal obstruction?

Bowel obstruction may be classified by 5 different classification methods including: Open and closed, incomplete and complete, extrinsic, intrinsic and intraluminal, true and pseudo-obstruction, and finally, small bowel and large bowel.

What are the basic categories of intestinal obstruction?

The most common causes of obstruction are adhesions, hernias, and tumors, a small-bowel obstruction in the absence of prior surgery or hernias is often caused by a tumor. Vomiting and third spacing of fluid cause volume depletion. Prolonged obstruction can cause bowel ischemia, infarction, and perforation.

Which is a characteristic of mechanical obstruction?

In mechanical obstruction, imaging reveals enlarged bow-shaped loops of small intestine with steplike air-fluid levels, the colon may have a paucity of gas distal to the lesion on plain radiographs, as demonstrated in the images below. Mechanical bowel obstruction due to a left colon carcinoma.

What is the most common complication which a patient with a small bowel obstruction might experience?

Potential Complications from a bowel obstruction

This leads to dehydration and kidney failure. Nausea and vomiting will also cause dehydration. Excess swelling of the intestine can cause the intestine to rupture or burst. A ruptured intestine can lead to peritonitis, or a severe infection in the abdominal cavity.

What initially is the primary concern when a patient is found to have a bowel obstruction?

Most bowel obstructions will require hospital admission and surgical consultation. Prompt recognition and diagnosis are critical in improving morbidity and mortality. The most important step in the initial management of bowel obstruction is identifying the type, severity, and cause.

Can you palpate a bowel obstruction?

Palpate for focal tenderness* (including guarding and rebound tenderness on palpation). Percussion may reveal a tympanic sound and auscultation may reveal ‘tinkling’ bowel sounds, both signs characteristic of bowel obstruction.

What are the signs and symptoms of small bowel obstruction?

Signs and symptoms of intestinal obstruction include:

  • Crampy abdominal pain that comes and goes.
  • Loss of appetite.
  • Constipation.
  • Vomiting.
  • Inability to have a bowel movement or pass gas.
  • Swelling of the abdomen.

What are the mechanical causes of intestinal obstruction?

Adhesions, hernias, and large bowel cancer are the most common causes of obstruction, as well as of bowel ischemia, necrosis, and perforation.

What does adhesions look like?

Adhesions may appear as thin sheets of tissue similar to plastic wrap or as thick fibrous bands. The adhesion develops when the body’s repair mechanisms respond to any tissue disturbance, such as surgery, infection, trauma, or radiation, resulting in inflammation.

What is intestinal obstruction Slideshare?

INTESTINAL OBSTRUCTION IS CLASSIFIED IN TWO TYPES  DYNAMIC : where peristalsis is working against a mechanical obstruction.  ADYNAMIC: it may occur in two forms 1. 1st where peristalsis may be absent (paralytic ileus,)occurring secondarily to neuromuscular failure in the mesentery. 2.

What is the management of intestinal obstruction?

Treatment. Management of intestinal obstruction is directed at correcting physiologic derangements caused by the obstruction, bowel rest, and removing the source of obstruction. The former is addressed by intravenous fluid resuscitation with isotonic fluid.

In what features do you differentiate small bowel obstruction and large bowel obstruction?

In small bowel obstruction, the pain tends to be colicky (cramping and intermittent) in nature, with spasms lasting a few minutes. The pain tends to be central and mid-abdominal. Vomiting may occur before constipation. In large bowel obstruction, the pain is felt lower in the abdomen and the spasms last longer.

What indicates an intestinal obstruction due to paralytic ileus?

Paralytic ileus is marked by abdominal distension, absent bowel sounds and relatively little pain (as compared to mechanical obstruction). Early paralytic ileus is marked by decreased or absent bowel sounds. Paralytic ileus may lead to complications causing jaundice and electrolyte imbalance.

What is the most commonly occurring small intestinal obstruction?

The most common cause of small-bowel obstruction (SBO) in developed countries is intra-abdominal adhesions, accounting for approximately 65% to 75% of cases. Postoperative adhesions can be the cause of acute obstruction within 4 weeks of surgery or of chronic obstruction decades later.

How can you distinguish between mechanical and functional obstruction?

There are two types of small bowel obstruction:

  • functional — there is no physical blockage, however, the bowels are not moving food through the digestive tract.
  • mechanical — there is a blockage preventing the movement of food.

Which of the following may result in a mechanical bowel obstruction?

Mechanical causes of intestinal obstruction may include: Adhesions or scar tissue that forms after surgery. Foreign bodies (objects that are swallowed and block the intestines) Gallstones (rare)

What are the risk factors for small bowel obstruction?

Risk Factors

  • Hernias.
  • Crohn disease —an inflammatory bowel condition.
  • Abdominal, joint, or spine surgery.
  • Swallowing a foreign body.
  • Decreased blood supply to the small bowel.
  • Abnormal growth of tissue in or next to the small intestine.
  • Tumors in the small intestine.
  • Cancer.

Does a bowel obstruction cause fever?

A bowel obstruction becomes an emergency if your abdominal pain increases and you start to experience a fever. This could be a sign of intestinal rupture, which can become life threatening.

What would happen if there was a blockage in the large intestine?

A bowel blockage can stop blood flow, causing part of the intestine to die. As pressure builds up from the blockage, intestinal bacteria can leak into the bloodstream. You may develop peritonitis, an abdominal infection. You are also at risk for a life-threatening system-wide infection called sepsis.

What is percussion in physical examination?

Percussion is a method of tapping body parts with fingers, hands, or small instruments as part of a physical examination. It is done to determine: The size, consistency, and borders of body organs. The presence or absence of fluid in body areas.

Which elements of a patient’s abdomen should be assessed on inspection?

Inspection consists of visual examination of the abdomen with note made of the shape of the abdomen, skin abnormalities, abdominal masses, and the movement of the abdominal wall with respiration.

Which is a normal finding when Percussing the abdominal area?

Normal findings on percussion include tympany over the stomach, epigastric area, and upper midline, and dullness over the liver, a full bladder, a pregnant uterus and the left lower quadrant over the sigmoid colon (if the patient is ready to have a bowel movement).

How is intestinal Malrotation diagnosed?

To confirm a diagnosis of intestinal malrotation, patients have various blood tests and diagnostic imaging studies done. These tests include: Abdominal X-ray – Reveals any intestinal obstruction. Barium swallow upper GI test – Examines the small intestine for abnormalities and to check the position of the jejunum.

Is intestinal obstruction the same as bowel obstruction?

A bowel obstruction is a serious problem that happens when something blocks your bowels, either your large or small intestine. It’s also known as an intestinal obstruction. If your digestive system comes to a grinding halt, you can’t have a bowel movement or pass gas.

What is mechanical obstruction?

Mechanical obstructions are when something physically blocks the small intestine. This can be due to: adhesions: fibrous tissue that develops after abdominal surgery. volvulus: twisting of the intestines. intussusception: “telescoping,” or pushing of one segment of intestine into the next section.

How can you tell the difference between intestinal obstruction and paralytic ileus?


Nausea, abdominal pain, bloating with vomiting, abdominal distention and obstipation being accompanying symptoms. Classically paralytic ileus is suggested by hypoactive bowel sounds whereas small bowel obstruction is described with rushes and bowel sounds consistent with peristalsis against the obstruction.

How are abdominal adhesions diagnosed?

The diagnosis of abdominal adhesions is typically done with the assistance of laparoscopy. This procedure involves using a camera to visualize the organs within the abdominal cavity. Routine tests such as X-rays, CT scans, and blood work are useless in diagnosing the adhesion itself.

How do you know if you have abdominal adhesions?

In many cases, abdominal adhesions do not cause symptoms. If they do cause symptoms, chronic abdominal pain is the most common symptom. Abdominal adhesions may cause intestinal obstruction, which can be life-threatening. If you have symptoms of intestinal obstruction, seek medical help right away.

What is intestinal adhesion?

Abdominal adhesions are bands of scar tissue that form between abdominal organs, mainly the small intestine. Adhesions occur after abdominal surgery and can cause your tissues to stick together, when normally they would just move around freely.

What do you mean by intestinal obstruction?

A partial or complete block of the small or large intestine that keeps food, liquid, gas, and stool from moving through the intestines in a normal way.

What is the difference between dynamic and Adynamic intestinal obstruction?

Intestinal obstruction may be divided into mechanical (dynamic) and non-mechanical (adynamic) causes. Mechanical (dynamic) obstruction In mechanical obstruction there is a physical obstruction of the bowel lumen associated with increased peristalsis in an attempt to overcome the blockage.

What is dynamic intestinal obstruction?

Dynamic bowel obstruction, a type of bowel obstruction in which the peristalsis is working against an. obstructing agent, is s a common surgical emergency globally with high morbidity and mortality (Zahra &amp, Sultan, 2004, Baloch et al, 2002, Ismail et al. 2005). An estimated 20% of hospital general surgical emergency.