Presentation
Lipoma within jejunal duplication presenting as abdominal bloating and partial intestinal obstruction is an exceptional clinical entity. [ncbi.nlm.nih.gov]
More information Case Presentation. Maha Akkawi, MD, Fatima Obeidat, MD, Tariq Aladily, MD. [healthdocbox.com]
Entire Body System
- Collapse
The small bowel is disproportionately dilated compared the the large bowel which is collapsed. There is no air in the rectosigmoid (white arrow). [learningradiology.com]
CT scan revealed a transition point between dilated proximal loops of small bowel and collapsed distal loops. [omicsonline.org]
Something outside the GI tract can also cause an obstruction if it presses on and collapses the GI tract. When there is a blockage, the intestinal contractions that move the food can cause intense pain. These movements are called peristalsis. [cancer.net]
[…] obstruction Adhesions – fibrous tissues that develops usually after abdominal or pelvic surgery Volvulus – otherwise known as a twisted bowel Intussusception – ‘telescoping’ of the bowel, when a segment of bowel pushes into another segment causing it to collapse [bladderandbowel.org]
Inflammatory Bowel Disease — a condition in which the walls of the intestine become inflamed Tumors in the intestine that impede the flow A volvulus, or a twisting of the intestine Intussusception, a condition in which a segment of the intestine collapses [ddc.musc.edu]
- Severe Pain
The blockage may cause severe pain that comes and goes. This topic covers a blockage caused by tumors, scar tissue, or twisting or narrowing of the intestines. [cigna.com]
The blockage may cause severe pain that comes and goes. This topic covers a blockage caused by tumours, scar tissue, or twisting or narrowing of the intestines. [healthlinkbc.ca]
If you are not in severe pain (trust me, you will know the pain I am referring to if it happens to you) and have some stool output either through your stoma or rectum/anus, it is most likely a partial obstruction. [crohnsdisease.com]
Fentanyl patch for controlling stable, moderate to severe pain in patients with/ or at risk of peristaltic failure is less constipating than morphine or oxycodone Mechanical obstruction Target treatment at the predominant symptom(s). [palliativecareguidelines.scot.nhs.uk]
- Inguinal Hernia
Manual reduction of inguinal hernia is unacceptable. [elearning.sumdu.edu.ua]
Parents may see a bulge in the groin area when an inguinal hernia is present. Incarceration occurs only rarely after eight years of age. [healthofchildren.com]
It is also important to look for possible causes of obstruction such as inguinal hernias so always include a genitourinary examination. [saem.org]
Femoral hernia is at high risk of obstruction. Inguinal hernia is a lower risk factor but it is much more common. Place a stethoscope on the abdomen to listen for bowel sounds. [patient.info]
(abdominal wall, inguinal, or femoral): note that if hernia contents are soft and reducible, the hernia is unlikely the cause of the obstruction. [clinicaladvisor.com]
- Constitutional Symptom
• ATTEMPT TO DISTINGUISH THE DIFFERENCE BETWEEN: • INCARCERATION • SLIDING • OBSTRUCTION • STRANGULATION IS NOTED BY: • PERSISTENT PAIN • DISCOLOURATION • TENDERNESS • CONSTITUTIONAL SYMPTOMS 11. [slideshare.net]
- Pathologist
It also allows the pathologist to determine the stage of the cancer accurately. This will allow your healthcare providers to determine if you need more treatment after you recover from surgery. [summitmedicalgroup.com]
Gastrointestinal
- Abdominal Distension
The following symptoms may be experienced with cecal volvulus: ballooning abdomen (abdominal distension) constipation diarrhea trouble passing gas severe abdominal pain vomiting Diagnosing cecal volvulus may be difficult because its symptoms mimic those [healthline.com]
Clinical features Classic presentations of small bowel obstruction include: crampy abdominal pain nausea and vomiting abdominal distension constipation. [surgwiki.com]
Abdominal distension will be apparent. It may be worth measuring abdominal girth to monitor progress. Massive peristalsis may even by visible. Distended bowel is very resonant on percussion. [patient.info]
On physical exam the patient has marked abdominal distension and is tympanic to percussion. Laboratory studies are notable for a lactic acidosis. [medbullets.com]
Any patient who has had previous abdominal surgery and presents with abdominal pain, distension, vomiting and decreased flatus should be considered to have a small bowel obstruction. [saem.org]
- Chronic Abdominal Pain
Chronic abdominal pain or the fear of pain is a common complaint in children with chronic intestinal pseudo-obstruction and may be treated with behavioral or relaxation therapy as well as with non-narcotic medicines. [chp.edu]
[…] obstruction, chronic abdominal pain, pelvic pain, and infertility.[28] Other animals[edit] References[edit] ^ a b c d e f g h i j k l Gore RM, Silvers RI, Thakrar KH, Wenzke DR, Mehta UK, Newmark GM, Berlin JW (November 2015). [en.wikipedia.org]
- Borborygmi
Physical examination typically shows a distended abdomen with loud borborygmi. There is no tenderness, and the rectum is usually empty. A mass corresponding to the site of an obstructing tumor may be palpable. [merckmanuals.com]
- Failure to Thrive
Between birth and age two, these children will likely develop other symptoms, such as chronic constipation, small watery stools, a distended abdomen, vomiting, poor appetite, slow weight gain, and failure to thrive. [healthofchildren.com]
Common clinical findings include chronic abdominal pain, intermittent vomiting, weight loss, failure to thrive, malabsorption, and diarrhea. Vomiting is either bilious or nonbilious. [elearning.sumdu.edu.ua]
- Periumbilical Pain
Condition Presentation Diagnosis Management Appendicitis[14] Abdominal pain, nausea, vomiting, fever Periumbilical pain, migrates to RLQ Clinical (history & physical exam) Abdominal CT Patient made NPO (nothing by mouth) IV fluids as needed General surgery [en.wikipedia.org]
Case 4 A 22-year-old woman was admitted to the hospital with right abdominal pain, nausea and vomiting. She mentioned that the abdominal pain had migrated to the right lower abdomen 12 hours after onset of periumbilical pain. [wjes.biomedcentral.com]
Cardiovascular
- Palpitations
She complained of a long history of subjective flushing, but denied wheezing and palpitations. She was felt to have a possible bowel obstruction, and an abdominal CT scan was performed that showed a mass near the terminal ileum. [healio.com]
Musculoskeletal
- Muscle Cramp
cramps Prevention of Intestinal Obstruction Follow a high-fiber diet. [healthcommunities.com]
Skin
- Sweating
Vomiting also initiates an SNS response causing both sweating and increased heart rate. [en.wikipedia.org]
Being confused and losing a sense of time and place, with rapid heartbeat, sweating, fever, and high or low blood pressure. These symptoms should be reported to the health care provider. [cancer.gov]
Psychiatrical
- Fear
Chronic abdominal pain or the fear of pain is a common complaint in children with chronic intestinal pseudo-obstruction and may be treated with behavioral or relaxation therapy as well as with non-narcotic medicines. [chp.edu]
In addition to cancelling planned surgeries, therapy has allowed our bowel obstruction patients to manage their own symptoms, without fear of any additional bowel obstructions. [clearpassage.com]
The most feared complication of diverticulitis is perforation and peritonitis, with the need for emergency surgery and creation of a colostomy. [fascrs.org]
[…] benefit to indigenous peoples of the Amazon, in helping to clear parasites from the gastrointestinal system.[33] There have also been documented cases of a single ill and vomiting individual inadvertently causing others to vomit, when they are especially fearful [en.wikipedia.org]
Neurologic
- Irritability
Abstract Both endometriosis and irritable bowel syndrome (IBS) are commonly found in young women and the diagnosis of either is challenging. [karger.com]
Common causes of pain in the abdomen include gastroenteritis and irritable bowel syndrome.[2] About 15% of people have a more serious underlying condition such as appendicitis, leaking or ruptured abdominal aortic aneurysm, diverticulitis, or ectopic [en.wikipedia.org]
Colon Cancer Screening Colonoscopy Endoscopy (EGD) ERCP Office evaluation of Heartburn, Reflux (GERD), Ulcers, and Gastritis Management of Helicobacter Pylori, Barrett’s Esophagus, Celiac Disease, Irritable Bowel Syndrome (IBS) Diagnostic evaluation of [ddcorlando.com]
[…] emptying (gastroparesis) Urinary infection Blood clot in intestinal arteries causing acute ischemic colitis In women: abdominal or pelvic adhesions, abortion, ovarian cancer or torsion, painful menstruation, endometriosis, pelvic inflammatory disease Irritable [healthhype.com]
Ulcerative Colitis Ulcerative colitis (UC) is an irritable bowel disease (IBD) that causes inflammation and sores, called ulcers, in the lining of the rectum and colon. [wexnermedical.osu.edu]
- Stroke
It may occur in association with a number of medical conditions including: [ 5 ] Chest infection Acute myocardial infarction Stroke Acute kidney injury Puerperium Trauma Severe hypothyroidism Electrolyte disturbance Diabetic ketoacidosis Postoperative [patient.info]
Other risks of surgery include, but are not limited to, post-operative pneumonia, heart attack, stroke, blood clots in the legs, organ failure, and even death. [fascrs.org]
Stroke or other disorders that cause paralysis of part of the body. Peripheral neuropathy (pain, numbness, tingling) of feet. Weakness of the diaphragm (the breathing muscle below the lungs ) or abdominal muscles. [cancer.gov]
- Forgetful
That does not mean you should just go about your day and forget what is happening to your body. It means you have been given a chance to help yourself before it gets to a more dire state. [crohnsdisease.com]
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Workup
See Workup for more detail. [emedicine.medscape.com]
Surgical Bowel obstruction requires a swift workup to establish whether emergent surgery is necessary! References: [1] [amboss.com]
[…] complete blood count, urine pregnancy test followed with quantitative blood beta-hCG Imaging: transvaginal ultrasound If patient is unstable: IV fluid resuscitation, urgent obstetrics and gynecology consultation If patient is stable: continue diagnostic workup [en.wikipedia.org]
Treatment
Treatment was continued with Taxol(R) and resulted in total cure of the ileus with reduction of palpable tumor mass over 24 h without necessitating any surgery. [ncbi.nlm.nih.gov]
In small bowel obstruction, treatment is often non-surgical. [healthhype.com]
Br J Clin Pract, 1990, vol. 44 (pg. 243 - 4 ) 4 Comparative efficacy of albendazole and three brands of mebendazole in the treatment of ascariasis and trichuriasis, East Afr Med J, 2004, vol. 81 (pg. 134 - 8 ) 5 Selective mass treatment with ivermectin [academic.oup.com]
To avoid unnecessary radicality in treatment, colon tumors with an uncertain preoperative diagnosis should undergo further diagnostic steps in order to clarify their nature. [hungary.pure.elsevier.com]
Prognosis
Citation metadata Abstract : Introduction: The aim of this study was to evaluate the characteristic features and both early and late term prognosis of premature infants who were followed-up with NEC in the neonatal intensive care unit. [go.gale.com]
Prognosis is good, if treatment starts early. On the other hand, severe untreated bowel obstruction with strangulation regularly ends with death. In small bowel obstruction, treatment is often non-surgical. [healthhype.com]
Prognosis[edit] The prognosis for non-ischemic cases of SBO is good with mortality rates of 3–5%, while prognosis for SBO with ischemia is fair with mortality rates as high as 30%.[26] Cases of SBO related to cancer are more complicated and require additional [en.wikipedia.org]
Etiology
The most important etiological factors were prematurity, hypoxia and enteral feeding. [go.gale.com]
Mechanical bowel obstruction : disturbance of bowel passage due to a structural barrier, resulting in disruption of intestinal transit Paralytic ileus : temporarily impaired peristalsis of the gastrointestinal tract in the absence of mechanical obstruction Etiology [amboss.com]
Luminal contrast studies computed tomography (CT scan) ultrasonography (US) Once the diagnosis of bowel obstruction is entertained, location, severity and etiology are to be determined. [ddc.musc.edu]
The etiology of the obstruction varies greatly, depending on the age that it occurs and the past surgical history. [elearning.sumdu.edu.ua]
[…] small bowel decompression and intravenous fluids o Surgical intervention may be necessary if there are signs and symptoms of strangulation, peritonitis or lack of response to conservative treatment Differentiating SBO from Paralytic Ileus SBO Ileus Etiology [learningradiology.com]
Epidemiology
“Epidemiology of pediatric inflammatory bowel disease: A systematic review of international trends”. Inflammatory Bowel Disease 2011; 17 (1), 423–439. Castro M., Papadatou B., Baldassare M., Balli F. et al. [ragazzicoraggiosi.it]
Colonic diverticulosis and diverticular disease: Epidemiology, risk factors, and pathogenesis. https://www.uptodate.com/contents/search. Accessed July 24, 2018. Tursi A, et al. [mayoclinic.org]
Insights from a population-based epidemiological study and implications in surgical management. Ann Surg 253:223–230 PubMed CrossRef Google Scholar Yousefzadeh DK (1983) Tubular colonic duplication: review of 1876–1981 literature. [link.springer.com]
Epidemiology Of all patients admitted to hospital with intestinal obstruction, most have small intestinal obstruction. Significant numbers of colorectal malignancies present with obstruction. [patient.info]
[…] transfusion If patient is unstable: general or trauma surgery consultation with subsequent exploratory laparotomy and possible splenectomy If patient is stable: medical management, consultation of interventional radiology for possible arterial embolization Epidemiology [en.wikipedia.org]
Pathophysiology
In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Accessed Sept. 10, 2015. Glancy DG. Intestinal obstruction. [mayoclinic.org]
Andrus CH, Ponsky JL (1988) Bezoars: classification, pathophysiology, and treatment.Am J Gastroenterol 83: 476-478. [omicsonline.org]
[…] common), tumors, Meckel diverticulum, Crohn disease (uncommon), Ascaris infestation, midgut volvulus, intussusception by tumor (rare), foreign body, and gallstones (rare) Neonates Meconium ileus, volvulus of a malrotated gut, atresia, intussusception Pathophysiology [merckmanuals.com]
[citation needed] Pathophysiology Receptors on the floor of the fourth ventricle of the brain represent a chemoreceptor trigger zone, known as the area postrema, stimulation of which can lead to vomiting. [en.wikipedia.org]
Prevention
CASE REPORT - A protruding, ulcerated and firm tumor preventing the investigation of the coecum was found by endoscopy in the ascending colon of a 50-year-old woman, who was subsequently operated on. [hungary.pure.elsevier.com]
Presently there are no therapies to prevent small bowel obstruction except avoiding the risks (such as surgical techniques to avoid adhesions, which are being explored) or lysis of existing adhesions to prevent some recurrences. [metrowestdailynews.com]
When to Contact a Medical Professional Call your provider if you: Cannot pass stool or gas Have a swollen abdomen (distention) that does not go away Keep vomiting Prevention Prevention depends on the cause. [mountsinai.org]
However, this highly complex operations usually will necessitate the creation of a temporary colostomy in order to prevent the passage of feces into the freshly reconstructed anus. [colonandrectalspecialists.com]
When to Contact a Medical Professional Call your health care provider if you: Cannot pass stool or gas Have a swollen abdomen (distention) that does not go away Keep vomiting Prevention Prevention depends on the cause. [nicklauschildrens.org]