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Intestinal Obstruction-Types-Causes-Clinical Signs-Treatment


Intestinal Obstruction:
Intestinal Obstruction is defined as a partial or complete blockage of the bowel that results in the failure of intestinal contents to pass through it.



Types:
Intestinal obstruction can be classified into 2 types

Dynamic
Adynamic
Peristalsis is working against a mechanical obstruction. It may occur in an acute or chronic form of mechanical obstruction
Peristalsis Absent
     The obstructing lesion may be:
  1. Intraluminal (Ex. impacted faeces, foreign bodies, gallstones)
  2.  Intramural (Ex. malignant or inflammatory strictures)
  3. Extramural (Ex. intraperitoneal bands and adhesions, hernias, volvulus or intussusceptions.)
l  ILEUS, esp. post surgical
¡  INFARCTION
¡  MOTILITY DISEASES, esp., HIRSCHSPRUNG DISEASE

Other Classification.
According to;
  1. Onset: Acute (sudden onset) and Chronic (slow onset) obstruction
  2. Site: Small intestine obstruction (also called high obstruction) and Large intestine obstruction (also called low obstruction
  3. Nature: Simple (blood supply do not compromise) and strangulated(blood supply may compromise)
Causes
¡ADHESIONS (post-surgical)
¡IMPACTION
¡HERNIAS
¡VOLVULUS
¡INTUSSUSCEPTION
¡TUMORS
¡INFLAMMATION, such as IBD (Crohn) or diverticulitis
¡STRICTURES / ATRESIA
¡STONES, FECALITHS, FOREIGN BODIES
¡CONGENITAL BANDS, MECONIUM, IMPERFORATED ANUS
intestinal-obstruction image

Clinical Signs and Symptoms:
l Abdominal Pain
l Abdominal distention
l Vomiting.
l Constipation.


Treatment
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Some causes of bowel obstruction may resolve spontaneously; many require operative treatment.
In adults, frequently the surgical intervention and the treatment of the causative lesion are required. In malignant large bowel obstruction, endoscopically placed self-expanding metal stents may be used to temporarily relieve the obstruction as a bridge to surgery, or as palliation.
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