Overview:
- A bowel obstruction is a serious problem that happens when something blocks bowels, either large or small intestine.
It’s also known as an intestinal obstruction.
It leads to stop bowel movement or pass gases.
- If bowel obstruction is not treated quickly, it may lead to bowel necrosis and perforation which causes peritonitis (a life-threatening condition)
Etiology:
- intestinal lumen is blocked by presence of objects in it (such as a fecal plug, passage of a biliary stone into intestine or orally intake foreign objects)
- obstruction is sometimes caused by thickening of the intestinal wall itself (as in Crohn’s disease and in colon tumors)
- obstruction is sometimes caused by pressure on intestine wall from outside (as in case of abdominal adhesions after surgery and intestinal strangulation at neck of abdominal hernial sac)
- Ileus (false obstruction): it happens as a result of bowel movements disorder, which affects movement of food inside.
It occurs after abdominal surgery
Parkinson’s disease,
severe infection
medications such as antidepressants and opioid analgesics.
Symptoms:
- Persistent or intermittent severe abdominal pain
- Nausea and vomiting
- Constipation
- bloating
- Loss of appetite
Causes:
The most important causes that lead to intestinal obstruction are:
- Intestinal intussusception in children
- Intestinal atresia in children
- Intestinal adhesions after abdominal surgeries
- Ulcerative colitis
- Crohn’s disease
- Abdominal hernias
- Bowel tumors
- Tumors of abdominal cavity
Diagnosis:
- Careful clinical examination
- Laboratory tests: monitor fluid and electrolyte balance and detect infections early
- Radiological investigations: X-ray, ultrasound and CT abdomen
Treatment:
- Life support by:
- intravenous fluids and electrolytes
- nil per mouth
- nasal gastric tube incretion: to relieve pressure on the digestive system
- then every case has a specific treatment:
- intussusception:
- Barium enema is both a diagnostic and therapeutic procedure as it can release intussusception
- Surgery if Barium enema fails
- partial obstruction: treatment is by careful monitoring of the patient’s condition
surgery if conservative treatment fails
- total obstruction: treatment with early surgery
- ileus treatment: careful monitoring
stop all drugs causing ileus
may resort to surgery in rare cases.
