Intestinal+Obstruction

Complete arrest or serious impairment to the passage of intestinal contents ileus or mechanical

Ileus
1. temporary arrest of intestinal peristalsis 2. usually with intra-peritoneal infection

Signs & Symptoms
a. abd distention, V, obstipation, cramps b. silent to auscultation c. “a silent abdomen demands a laparotomy”

Treatment
a. if >1wk, also mechanical - surgery

Mechanical
1. simple or strangulating a. strangulating type cuts off blood flow

Etiology
a. adhesions, hernias, tumors, foreign bodies, IBD, fecal impaction, volvulus, Hirschprung’s

Signs & Symptoms
---cramps around umbilicus ---Vomiting ---obstipation [obstinate constipation] ---strangulation occurs in 25% of SI obstruction and can progress to gangrene in 6 hrs ---no tenderness if no strangulation ---high pitched peristalsis with cramps ---tenderness, distention, silence with strangulation ---dx by x-ray, laparotomy ---more gradual appearance of sx ---inc constipation, obstipation, distention ---lower abd cramps ---distended abdomen with loud borborygmus ---possible palpable mass ---dx by x-ray, endoscopy, barium enema
 * Small Intestine**
 * Large Intestine**

Treatment
every pt. with possible obstruction should be hospitalized