|Cardinal features of intestinal obstruction: vomiting, colicky pain, constipation and distension|
Cardinal features of bowel obstruction?
|Video: Bowel Obstruction Overview|
Is it a partial or complete bowel obstruction?
Is it obstruction of the small or large bowel?
|DIFFERENCE BETWEEN SMALL AND LARGE BOWEL OBSTRUCTION|
|Small Bowel||Large bowel||Ileus|
|Main Aetiology (in order)||Adhesions, Hernia, Cancer||Cancer, Diverticulitis, Volvulus||Post operative, medication, chronic disease|
|Nausea,vomiting||Early, may be bilious||Late may be faeculent||Present|
|Abdominal Pain and Distension||Colicky and slight distention +||Colicky and distended ++||Minimal or absent|
|Bowel Sounds||Normal, initially increased and may decrease late||Normal, initially increased and may decrease late||Decreased or absent|
|Remember Ileus is temporary paralysis of the myenteric plexus. Contents of the small intestine are acutely unable to transit because of impermanent neural or muscular inadequacy.|
Mechanical obstruction or ileus?
Pseudo-obstruction (non-mechanical obstruction)
|Remember Pseudo-obstruction refers to intestinal dysmotility syndromes that have signs, symptoms, and the radiologic appearance of obstruction in the absence of a mechanical cause|
Absence or presence of intestinal ischemia (simple or strangulated)
|X-RAY DIFFERENCES OF SMALL AND LARGE BOWEL|
|Small bowel||Large bowel|
|Content||Fluid and air||Faecal matter|
|Wall Patern||Encircling valvulae conniventes visible depending on degree of air filling/distention.||Haustral folds interspaced with Plicae semilunaris|
|Size||3cm diameter||6cm diameter (caecum 9cm)|
|3, 6, 9 Rule|
|Small intestine 3cm|
|Large intestine 6cm|
|Remember Any increase in these numbers signify dilatation most likely due to an obstruction|