TOPIC:- INTESTINAL

OBSTRUCTION

PRESENTED BY:- Sachin Vyas

NPCC PG 1st
 INTESTINAL OBSTRUCTION

• The intestinal contents are obstructed to

z
travel from the proximal part to distal
z part.

*CONGENITAL:- intestinal atresia, This Photo by Unknown author is licensed under CC BY-SA-NC.

congenital megacolon
etc.

*ACQUIRED:- hernia, intussusception

Classification:-

1.Acc. to nature of obstruction-

z
Dynamic-Paristalsis working
Adynamic- (-) ve Moving

2.Acc. To blood supply-

Simple obstruction- 90%
Strangulation-10%
Acc. To cause of obstruction:-

Intra-luminal:- Gallbladder, Roundworms, Faeces etc.

Intra-mural:- Tuberculosis, Stricture, Malignancy etc.

Extra-luminal:-Adhesion, Hernia, Volvulus,

intussusception etc.
Symptoms:-

# Abdominal pain(cramps- relives after 5-10 min)

* Central- small intestine
* Peripheral- large intestine

# Vomiting/Nausea:- (if obs. in small intestine) early in high

Small bowel obs., absent in large bowel

# Abdominal distension:- Central (epigastric and hypogastric)-

small intestine , peripheral- large
intestine

# Constipation:- early in large bowel obstruction

# Obstipation:- severe form of constipation where patient can

not pass stool or gas.
Signs:-
• Dehydration

• Blumberg's signs (Rebound tenderness)

• Rigidity of abdominal muscle

• Absence of bowel sound (not in early stage)

• Tachycardia

• Fever
Complication:-
1. Bowel ischemia – due to venous compression
2. Perforation – due to distension
3. Sepsis – due to perforation
Investigation:-

 CBC
 Serum electrolyte
 Barium meal shows F B
 Plain abdominal X-rays – supine & upright view
 USG abdomen
 2 enema test -
* After 1st enema – faces
* After 2nd enema – no faces
Treatment:-

Conservative:-
• Resuscitation – *NG tube for decompression
*B.P normal – release hypertension
*Fluid therapy – maintain electrolyte
level
*NBM (nill by mouth)
• Antiemetics
• Antipyretics
• NSAIDS
Surgical Management:-
Indication-
• If no resolution after 72 hours

• When complete blockage of the bowels

• Malignancy

• Perforation

• Strangulation

• gangrene
Health Education:-