Small bowel obstruction: Treatment, symptoms, advice & help
About small bowel obstruction
Small bowel (also called the small intestine); obstruction is a mechanical or functional obstruction of the intestines, preventing the normal movements of the products of digestion. It may occur at any level from the duodenum to the caecum and is a medical emergency.
It may be classified into two types: dynamic, in which peristalsis is working against a mechanical obstruction and adyanamic, in which peristalsis may be absent (e.g. paralytic ileus).
Signs & symptoms of small bowel obstruction: Diagnosis
The diagnosis of dynamic intestinal obstruction is based on the classic quartet of pain, distension, vomiting and absolute constipation.
An erect film may subsequently be requested when further doubt exists. When distended with gas, the jejunum, ileum, caecum have a characteristic appearance .In an adult, fluid levels are most prominent on an erect film. During the obstructive process, fluid levels become more conspicuous and more numerous when paralysis has occurred. When fluid levels are pronounced, the obstruction is advanced.
Causes and prevention of small bowel obstruction
The common causes of dynamic obstruction are a) intraluminal impaction with foreign bodies, bezoars, gallstones, intramural stricture, malignancy and b) extramural bands/adhesions, hernia, volvulus, intussusception. The common causes of dynamic obstruction are paralytic ileus, and mesenteric vascular occlusion.
Small bowel obstruction: Complications
Late manifestations of intestinal obstruction that may be encountered include dehydration, oliguria, hypovolemic shock, pyrexia, septicaemia, respiratory embarrassment and peritonitis.
Small bowel obstruction: Treatment
Treatment of acute intestinal obstruction includes gastrointestinal drainage, fluid and electrolyte replacement and relief of obstruction. Surgical treatment is necessary for most cases of intestinal obstruction but should be delayed until resuscitation is complete, provided there is no sign of strangulation or evidence of closed-loop obstruction.