Intestinal obstruction presents several distinct signs and symptoms that are crucial for diagnosis. Firstly, distension is a key indicator, where fluid and air accumulate proximal to the site of obstruction, causing the proximal bowel to dilate while the distal bowel collapses…CONTINUE READING>>...CONTINUE READING THE FULL ARTICLE>>>
It’s worth noting that much of the air in the dilated bowel is swallowed air, emphasizing the need for nasogastric aspiration.
The obstructed bowel accumulates various fluids, including gastric, biliary, and pancreatic juices. If the obstruction is high in the duodenum or upper jejunum, patients may not experience noticeable distension as they are likely to vomit and decompress the obstruction.
However, if the obstruction is more distal, abdominal distension occurs, and abdominal X-rays reveal characteristic air-fluid levels and ladder formation.
Pain is another hallmark of intestinal obstruction. The pain is colicky, originates around the periumbilical region, and comes in waves. Unlike pain from parietal peritoneum involvement, it does not localize to the affected area.
Moreover, fluid and electrolyte abnormalities are common in high small bowel obstruction, leading to severe vomiting, fluid volume contraction, and electrolyte imbalances, which can manifest as hypokalemic, hypochloremic metabolic alkalosis.
However, in low small bowel obstruction, fluid lost into the gut lumen and peritoneal cavity is iso-osmotic, resulting in less severe electrolyte imbalances.
Strangulated obstruction is a more severe condition, characterized by two sites of obstruction with a closed segment in between. This poses a higher risk due to potential complications like volvulus and vascular compromise.
The closed-loop segment undergoes changes that may lead to arterial compromise if not relieved, causing catastrophic consequences…CONTINUE READING>>
