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Partial Small Bowel Obstruction


Presentation

  • This is a report of a case of acute appendicitis in a patient with intestinal non-rotation presenting with partial small bowel obstruction. Analysis of the CT findings allowed a correct diagnosis.[ncbi.nlm.nih.gov]
  • We present a case of partial mechanical small bowel obstruction as a sequel of this syndrome that was diagnosed and treated laparoscopically.[ncbi.nlm.nih.gov]
  • We describe a case of a 30-year-old woman with a clinical presentation suggestive of appendicitis.[ncbi.nlm.nih.gov]
  • Abstract A case of distal ileal diverticulosis complicated by diverticulitis causing partial small bowel obstruction is presented.[ncbi.nlm.nih.gov]
  • Presentations: In the first month of life, the most typical presentation includes feeding intolerance with bilious (ie, yellow or green) vomiting and sudden onset of abdominal pain.[slideshare.net]
Vomiting
  • Obstruction of the intestines due to adhesions resulting from previous abdominal surgery is painful, results in vomiting and dehydration and requires urgent medical and often surgical intervention.[news-medical.net]
  • […] customers What is bowel obstruction i have been throwin for 4 days what is bowel obstruction i have been throwin for 4 days only have pain in the stomach just before i upchuck no pain anywhere else and no fever been 16 hrs since last episode bile in vomit[justanswer.com]
  • If you experience constipation, nausea, vomiting or abdominal pain when following your liquid diet for a partial bowel obstruction you should consult your physician immediately.[livestrong.com]
  • Then at 4 AM I started vomiting. I knew that wasn't normal, so I begrudgingly went to the ER thinking maybe I had food poisoning. They did a CT with contrast and found a partial small bowel obstruction.[obesityhelp.com]
  • The tube will remove any fluids or gas trapped in your stomach and relieve any pain and vomiting. You will not be able to have anything to eat or drink to avoid adding any pressure or bulk to the blockage.[bladderandbowel.org]
Nausea
  • Share this post Link to post Share on other sites evolvingrn works as a RN. 8,200 Visitors; 1,035 Posts They don't always need and NG tube. if the patient is not throwing up or feeling extreme nausea they will sometimes hold off and try bowel rest, movement[allnurses.com]
  • If you experience constipation, nausea, vomiting or abdominal pain when following your liquid diet for a partial bowel obstruction you should consult your physician immediately.[livestrong.com]
  • Criteria for admission into the study were: signs and symptoms consistent with PSBO (pain, distention, nausea, vomiting, and constipation), a history of abdominal surgery at least 4 weeks before enrollment, and a plain upright abdominal X-ray that showed[ahcmedia.com]
  • Typical symptoms are cramping abdominal pain, nausea, rumbling bowel sounds and cessation of gas.[healthhype.com]
  • I was recovering and ready to go back to work in a few weeks then I started experiencing the same severe pain with nausea and vomiting this time. They diagnosed partial small bowel obstruction. I had an NG tube and was NPO for bowel rest.[csn.cancer.org]
High Pitched Bowel Sounds
  • But often the distinguishing feature can be cramping abdominal pain and hyperactive or high pitched bowel sounds.[clinicaladvisor.com]
  • Clinical signs include abdominal distention, tympany due to an air-filled stomach and high-pitched bowel sounds. [ 9 ] History There is considerable overlap with the presentation of the various conditions although some features may be more prominent or[patient.info]
Hyperactive Bowel Sounds
  • Diagnosis: Factors predicting Bowel Obstruction History of prior surgery Constipation history Age over 50 years Vomiting Abdominal Distention Hyperactive bowel sounds X.[fpnotebook.com]
Decreased Bowel Sounds
  • Clinical features Signs of Ileus in the ICU patient can include abdominal distention, intolerance to enteral feeds, increased gastric output, increase in abdominal pressure, decreased flatus, decreased bowel sounds and decreased stool output.[clinicaladvisor.com]

Workup

  • Surgical Bowel obstruction requires a swift workup to establish whether emergent surgery is necessary! References: [1][amboss.com]
X-Ray Abnormal
  • Home » Tutorials » Abdominal X-ray Tutorials » Abdominal X-ray - Abnormal bowel gas pattern » Introduction » 1 2 3 4 5 6 » Conclusion Key points Dilated small bowel 3cm is considered abnormal Small bowel obstruction and ileus can have similar appearances[radiologymasterclass.co.uk]
Bowel Distention
  • ED) Test Sensitivity : 60% (up to 80-90% in high grade obstruction) False negative in early obstruction and high jejunal or duodenal obstruction Typical findings of Bowel Obstruction Bowel distention proximal to obstruction Bowel collapsed distal to obstruction[fpnotebook.com]

Treatment

  • Several advances in the treatment and prevention of SBO have become practice in past decade. This article reviews the clinical issues and technical advances of this challenging condition.[ncbi.nlm.nih.gov]
  • BACKGROUND: Nothing by mouth (NPO) is the standard treatment for small-bowel obstruction. Whether oral medications should be prohibited during treatment of adhesive, partial small-bowel obstruction is unclear.[ncbi.nlm.nih.gov]
  • Operation remains the most appropriate and definitive treatment for this complication and the laparoscopic approach is a feasible and safe surgical treatment option.[ncbi.nlm.nih.gov]
  • Ten obstructive episodes (21%) in the control group required operative treatment compared with six (10%) in the trial group (p 0.12).[ncbi.nlm.nih.gov]
  • […] and 1 had required surgical treatment) ( Table 2 ).[cmaj.ca]

Prognosis

  • Fevang BT, Fevang J, Lie SA, et al. (2004) Long-term prognosis after operation for adhesive small bowel obstruction. Ann Surg 240:193–201 PubMed CrossRef Google Scholar 4.[link.springer.com]
  • Outlook (Prognosis) The outcome depends on the cause of the blockage. Most of the time, the cause is easily treated.[nicklauschildrens.org]
  • Obstruction not associated with cancer has a very good prognosis, especially in otherwise healthy people.[drugs.com]
  • Prognosis Prognosis for ileus in the critically ill is based on underlying cause. However, delay in enteral nutrition has been shown to increase morbidity and trend to mortality.[clinicaladvisor.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]

Etiology

  • The predominant etiology continues to be postoperative adhesions, accounting for approximately two-thirds of all obstructive events.[ncbi.nlm.nih.gov]
  • CT abdomen provides detailed information including the possible etiology for obstruction. CT with PO and IV contrast has a sensitivity and specificity of 100 and 83%. If the bowel is ischemic, then specificity decreases to 61%.[lumen.luc.edu]
  • 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]
  • ADVERTISEMENT CT determines the location – and sometimes the etiology – of obstruction.[epmonthly.com]

Epidemiology

  • Epidemiology In one recent study, 16% of patients developed ileus while in the ICU. Approximately 300,000 patients undergo surgery for small bowel obstruction each year, most being secondary to adhesive disease.[clinicaladvisor.com]
  • 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]
  • Genta RM (1989) Global prevalence of strongyloidiasis: critical review with epidemiologic insights into the prevention of disseminated disease. Rev Infect Dis 11: 755-767.[omicsonline.org]
Sex distribution
Age distribution

Pathophysiology

  • In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. . Accessed Sept. 10, 2015. Glancy DG. Intestinal obstruction. Surgery. 2014;34:204.[mayoclinic.org]
  • Pathophysiology Ileus mechanism is complex but thought to be multifactorial, including stress induced sympathetic (inhibitory) reflexes, inflammatory mediators and effects of medications.[clinicaladvisor.com]
  • […] 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]
  • Pediatr Surg Int 25:795–798 PubMed CrossRef Google Scholar Carlyle BE, Borowitz DS, Glick PL (2012) A review of pathophysiology and management of fetuses and neonates with meconium ileus for the pediatric surgeon.[link.springer.com]
  • Pathophysiology: Process (Occurs quickly in closed loop obstruction) Obstruction forms in either Small Bowel (much more common) or Large Bowel Bowel dilates proximal to obstruction Flatus and Bowel Movement s cease Dehydration results from Vomiting, minimal[fpnotebook.com]

Prevention

  • Several advances in the treatment and prevention of SBO have become practice in past decade. This article reviews the clinical issues and technical advances of this challenging condition.[ncbi.nlm.nih.gov]
  • A bowel obstruction is the partial or complete blockage of areas of the small intestines, preventing food and digestive liquid from moving through.[livestrong.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]

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