Research submitted by

Student name: Ahmed Abdelraouf

Student ID:

Student No:16633

Course title: pathology

Research title (intestinal obstruction )

Under supervision of

Dr: Taghreed Abdelsamee3

 Table of contents page

Table of content II

Abstract III

Introduction 4

Type of Intestinal obstruction 5

Cause Intestinal obstruction 6

Complication 7

Conclusion 8
Summary 9

Reference 10
 Abstract
Acute bowel obstruction remains a significant clinical condition in Upper
Egyptian patients. From a clinico-histopathological standpoint, the
present research was conducted to focus on cases of acute intestinal
obstruction. The study was retrospective, with 186 patients from January
2009 to December 2017 diagnosed with acute intestinal obstruction. Male
patients were affected significantly more frequently than females. From
this analysis it is evident that acute on top of chronic intestinal
obstruction is still a big problem. The purpose of the research was to
identify the most common histopathological findings in typical cases of
acute bowel obstruction. In the listed biopsies, intestinal adenocarcinoma
took precedence of cases (27 %),Reactive hyperplasia of the mesenteric
lymph nodes (10%), non-Hodgkin's lymphoma (7%) and mesenteric
vascular occlusion (5%) followed. We found that patients with a
diagnosis of biopsy as adenocarcinoma and non-Hodgkin's lymphoma
had been talking about symptoms of persistent intestinal obstruction
several years before acute obstruction formed. From this point on,
therefore, doctors in all specialties (gastroenterology, surgery, and
histopathology) will strongly examine cases of chronic intestinal
obstruction, as such lesions also predispose to acute intestinal obstruction.
They will also keep an eye on any problem like acute bowel obstruction.
From this analysis we may establish many clinical consequences of acute
bowel obstruction, such as hemorrhagic infarction, intestinal gangrene,
and peritonitis.
 Introduction

Intestinal obstruction is a condition characterized by a blockage of

intestinal, gas and liquid material across small or large intestines. The
block must be complete and permanent. Many data will diversify the
syndrome of the intestinal obstructionFirst, the etiology focuses on a
large number of factors which require subdivision of mechanical and
functional / paralytic obstruction. The other characteristic characterizes
the syndrome: the obstruction seat around the intestine— the small upper
intestine, the small distal intestine, and the broad intestine.Eventually, the
cause of the obstruction may include an intestinal segment's vascular
supply[1] giving rise to strangulation obstruction that should be
differentiated from simple obstruction. The syndrome of intestinal
obstruction produces the same, overlapping, and pathophysiological
changes with these distinct etiopathological and clinical features

Types
 Small bowel obstruction Large bowel obstruction

Small bowel obstructions are generally caused by scar tissue hernia or cancer The
bowel also develops scar bands after being treated during surgery, the more scars are
likely to develop If the bowel is stuck in adhesions it may lead to small bowel
obstruction In extreme cases the blood flow can be disrupted and the bowel tissues
can die This is life-threatening

Large bowel obstruction (intestinal) occurs when there is a blockage in the large
bowel which prevents the passage of food and gas. The blockage reduces blood flow
to the intestine and a part of it dies. When this happens, the strain allows the bacteria
to spill into the body or blood. The most common symptoms include not being able to
move through gas or moving the intestines

Causes of obstruction include:

Small
Adhesions from previous abdominal surgery (most common cause)

Barbed sutures

Pseudo obstruction

Hernias containing bowel

Crohn's disease causing adhesions or inflammatory strictures

Neoplasm's, benign or malignant

Intussusceptions

Volvulus

Superior mesenteric artery syndrome, a compression of the duodenum by the superior

mesenteric artery and the abdominal aorta

Large
Neoplasms / cancer

Diverticulitis / Diverticulosis

Hernia

Inflammatory bowel disease

)Colonic volvulus (sigmoid, caecal, transverse colon

Adhesions
 Constipation

Fecal impaction

Fecaloma

Colon artesian

Intestinal pseudo obstruction

Endometriosis [3-5]

Complication
 Postoperative complications often arise in patients with an
obstruction. Wound infection, burst appendix, intestinal fistula
and septicemia extreme death due to respiratory tract infection
etc. are a few common complications. Complications like death
occurred in the present sample of 60 patients in 9 cases, wound
infection in two, burst appendix and bowel fistula in one each.
Septicemia in particular in cases of mesenteric ischaemia, those
that developed late and patients with other comorbid
conditions
 Conclusion
We could determine from this study many pathological effects of acute
intestinal obstruction, such as hemorrhagic infarction, intestinal gangrene,
We could determine from this study many pathological .and peritonitis
effects of acute intestinal obstruction, such as hemorrhagic infarction,
intestinal gangrene, and peritonitis. In our study, these effects represented
around (12 %) of the cases studied, half of which were caused by
hemorrhagic bowel infarction.
 Summary
Intestinal obstruction is a serious surgical emergency caused by a
mechanical blockage (dynamic obstruction) or peristalsis failure that
results in paralytic illus (a dynamic obstruction. Obstruction results in
fluid sequestration in the lumen of the intestine, with consequent
dehydration and electrolyte imbalances. Mechanical obstruction
contributes to the typical symptoms of abdominal colicky pain,
abdominal distension, constipation (especially with distal obstruction),
and vomiting (especially with proximal obstruction. Paralytic contrast, on
the contrast, is usually painless. Bowel ischemia and perforation can
complicate obstruction. A life-threatening situation ensues. Management
includes rapid resuscitation, followed by careful examination and tailor-
made care for the underlying cause.
 Reference

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