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Bowel Obstruction

In developed countries, approximately 50% of all small bowel obstructions are caused by adhesions, 15% by incarcerated or strangulated hernias, and 15% by neoplasms.

Causes

Causes of bowel obstruction include:

  • Hernias containing bowel
  • Neoplasms , benign
  • Foreign bodies (e.g. gallstones in gallstone ileus)
  • Intestinal atresia
  • Adhesions from previous abdominal surgery
  • Inflammatory bowel disease
  • Sigmoid or caecal volvulus
  • Faecal impaction
  • The most common cause of SBO is postsurgical adhesions.
    • Postoperative adhesions can be the cause of acute obstruction within 4 weeks of surgery or of chronic obstruction decades later.
    • The incidence of SBO parallels the increasing number of laparotomies performed in developing countries.

Symptoms

  • Abdominal pain +++++
  • Nausea ++++
  • Vomiting ++++
  • No flatus or stool passage
  • Bloating ++++
  • Inguinal pain or a bulge or mass in the scrotum if an incarcerated hernia is the cause of the obstruction

Signs

  • Abdominal distention ++++
  • Abdominal tenderness ++++
  • Fever ++
  • Tender palpable mass if hernia is present
  • Peritonitis if hernia is strangulated

Treatment

Nonsurgical treatments may help relieve symptoms, clear a bowel obstruction. These treatments may include:

  • Using enemas of air, barium, or a product such as Gastrografin usually can clear an obstruction that occurs when one part of the intestine folds like a telescope into another part.
  • In some cases of obstruction, doctors may place expandable metal tubes called stents in the large or small intestine to help intestinal contents move forward. If you need surgery, a doctor may place stents to help you gain strength before surgery. Stents may also provide an alternative to surgery, allowing you to avoid a colostomy and a colostomy bag .
  • Medicines, which can help relieve pain, nausea, and vomiting or help reduce the amount of stomach secretions.
   
   

 
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