INtestinal obstruction

Under supervision
Assist prof /fatma Abdelhaseb

Al/Hadeer Hamdy
 ‫‪Prepared by‬‬

‫‪ -1‬محمد طاهر يوسف عبد التواب‬

‫‪ -2‬محمد عادل أحمد سيد أحمد‬
‫‪ -3‬محمد عاطف شعبان حسن الماحى‬
‫‪ -4‬محمد عبدالعظيم عبدالسيد خليفه‬
‫‪ -5‬محمد عبدالعظيم على فوده‬
‫‪ -6‬محمد عبدالغنى عبد التواب سالم‬
‫‪ -7‬محمد عبدالغنى محمد جاب هللا‬
‫‪ -8‬محمد عبدالمنعم عبدالفتاح األخوص‬
‫‪ -9‬محمد عبدالنبى أبوالفتوح محمد على‬
‫‪ -10‬محمد عبدالنعيم مهدى محمد على‬
‫‪ -11‬محمد عصام شرف شرف ضيف‬
‫‪ -12‬محمد عطيه كامل شرشر‬

‫‪Outlines‬‬

‫•‬ ‫‪Introduction‬‬
‫•‬ ‫‪Definition‬‬
‫•‬ ‫‪Cause according age‬‬
‫•‬ ‫‪Classfication‬‬
Introduction
Intestinal obstruction occurs in approximately 1 in every 2,000 births
and is a frequent reason for pediatric surgical consultation. Several
different conditions fall under neonatal bowel obstruction; Obstruction
can occur at any point in the digestive system, and in addition to the
presence of general symptoms that combine these cases, there are
symptoms specific to each different case, and all of them share being
emergency cases that require immediate treatment to prevent
complications

Definition

partial or complete block of the small or large intestine that keeps food,
liquid, gas, and stool from moving through the intestines in a normal
way.

Causes of intestinal obstruction

Causes of intestinal obstruction according to age

At birth

 Atersia itis absence or closure of a natural passage of the body

such as an ovarian follicle
 meconium itis stick .thick dark green stool is made up of cells
.protein .fats and intestinal secretion
 Volvulus itis occurs when the intetine twists around it self and the
mesentary that support it it creating obstruction
 Hirschsprung,s itis diseaseis acondition that affects the large
intestine and causes problems with passing stool itis present at
birth result of missing nerve cells in the muscle of baby's colon

At3weeks ..
 pyloric stenosis ..un common condition in infants that blocks food from
entering small in testine
At 6-9months .

.intussception ..Itis rare serious disorder in which one part of the

intestine slides inside an part

At Teenage

• .. Appendicitis itis inflammation of the appendix afinger shaped

pouch that projects from colon on the lower side in the abdomen
• -Mackel,s diverticulitis ..itis congenital condition that present at
birth it is bulge in the lower part in the small intestine

At young adult

• Adhesion ..it is an attraction of molecules of one kind for

molecules of different kind it can strong by water
• Hernia ..Itis happen when apart of internal organ or tissue bulges
through aweak area of muscle

Adult

• Adehsion
• Hernia
• Appendicitis
• corhn,s carcinoma ..Itis achronic inflammation that typically
involves the lower portion of the ileum over speard to the colon

At Eldery

• Carcinoma ..itis acancer that begins in the

• skin or in tissues that cover internal organ
• Diverticulitis..it is Occur when small bulging pouches that develop
in digetive tract it become infalmmed or infected
 • Sigmoid volvulus ..It is acondition which the segmoid colon
wrapes around it self and itis own mesentary causing closed loop
obstruction

Classification
• .Cause of obstruction mechanical or functional (lleus)
• .Duration of obstruction: acute or chronic
• Extent of obstruction : partial or complete
• Type of obstruction : simple or complex (closed loop and
strangulation).

1- Classification according tocause

:Dynamicwhere peristalsis is working against amechanical obstruction.

There is physical blockage of intestinal lumen which due to:

1. Intramural: congenital-tumor-hematoma-inflammatory

2. Extramural: adhesion-volvulus-hernia -abscess-hematoma

3. Lumen obstruction: stone-meconium-foreign body-impaction (stool-

wormbarium)

This mechanical obstruction can be • partial

(lumen narrowed but allow transit some content)

or complete (lumen totally obstruction)

A dynamic: where there is absence of peristalsis without obstruction

Paralytic ilus

Mesenteric vascular occlusion

( Pseudo obstruction

2_ Classification according to anatomy

- Small bowel obstruction

 • -:Highaffect duodenum or jejunum.
• -:Lowaffect ileum

Large bowel obstruction-

3- Classification according to the nature of duration

1. Acute obstruction:

IT USUALLY OCCUR IN SMALL BOWEL OBSTRUCTION WITH SUDDEN AND

RABED ONSET OF SEVERE COLICKY CENTRAL ABDOMINAL PAIN,
DISTENTION AND EARLY VOMITING AND CONSTIPATION.

2. Chronic obstruction:

It has gradual onset , symptoms are incicious and

usually • affect large intestine. There is progressive

constipation, distension & abdominal colics.

3-ACUTE ON CHRONIC OBSTRUCTION

IT SATRTS IN LARGE BOWEL BUT GRADUALLY INVOLVES

THE➤
.SMALL INTESTINE

EARLY SYMPTOMS ARE PAIN AND CONSTIPATION BUT WHEN SMALL

INTESTINE IS INVOLVED IT IS CHARACTERIZED BY VOMITING AND
GENERAL DSTENTION.

4- Classification according totype

1-simple mechanical obstruction : obstruction of a gut by

an organic cause without interference of its blood supply

2-complex .

• Strangulation: impairment of blood supply of the affected

.bowel segment occurs

 .It is usually associated with hernia, volvulus, and intussusceptions

If strangulation is not relieved within 6

. hours → gangrene occurs

• Closed loop:- is a specific type of obstruction in which two points

along the course of a bowel are obstructed at a single location
thus forming a closed loop.

Usually this is due to adhesions, a twist of the mesentery or

internal* .herniation

In the large bowel it is known as a volvulus.

.In the small bowel it is simply known as small bowel closed loop
obstruction •