Intestinal obstruction

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What is Intestinal Obstruction?

Intestinal obstruction is an emergency condition due to mechanical obstruction of the small intestine due to various reasons.

1.Lesions outside the intestine e.g. adhesive fibrous bands, hernias.
2.Lesions within the wall of the intestine e.g. diverticulitis, cancer, chronic inflammatory
bowel disease.
3.Obstruction of the lumen of the intestine e.g. gall stones.

With obstruction of the intestine, distention takes place which is caused by the accumulation of gas and fluid proximal to the block. Blood flow is gradually compromised with the build-up of pressures within the intestine and as the intestine distends more and more, venous return to the heart is slowed down considerably. Severe loss of fluids into the distended segment occurs leading to electrolyte imbalance, renal failure, shock, and death.

Clinical Features of Intestinal obstruction

1. Cramping abdominal pain, which tends to be more severe, the higher the obstruction.
Pain occurs in paroxysms with periods of relative freedom.
2. Vomiting is projectile.
3. Constipation is present. No bowel sounds are heard.
4. Passage of wind stops.
5. Abdominal distention present.
6. Fever, the rigidity of the abdominal wall, tenderness, and shock signifies contamination of the
peritoneum with infected intestinal contents.

Management of Intestinal obstruction

1. Urgent evacuation to a hospital.
2. Surgery.

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