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]

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

  The classic symptoms of nausea, vomiting, abdominal pain, and constipation are rarely present in all cases of SBO. Abdominal pain associated with SBO is often described as crampy and intermittent. [emedicine.medscape.com]

  Classic Presentation History The patient with a small bowel obstruction will usually present with abdominal pain, abdominal distension, vomiting, and inability to pass flatus. In a proximal obstruction nausea and vomiting are more prevalent. [saem.org]

  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]

• 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]

  Radiation enteritis causes diarrhea, nausea, vomiting and stomach cramps in people receiving radiation aimed at the abdomen, pelvis or rectum. [mayoclinic.org]

  Typical symptoms are cramping abdominal pain, nausea, rumbling bowel sounds and cessation of gas. [healthhype.com]

  The classic symptoms of nausea, vomiting, abdominal pain, and constipation are rarely present in all cases of SBO. Abdominal pain associated with SBO is often described as crampy and intermittent. [emedicine.medscape.com]

• Hyperactive Bowel Sounds

  Signs Vital Sign s: Dehydration vs SIRS Criteria ( Sepsis ) Sinus Tachycardia Hypotension Bowel sounds Initial: High pitched, hyperactive bowel sounds Later: Hypoactive or absent bowel sounds Tender abdominal mass Closed loop Bowel Obstruction may be [fpnotebook.com]

  Physical Exam Physical examination findings include: abdominal distension (more prevalent in distal obstructions), hyperactive bowel sounds (early), or hypoactive bowel sounds (late). [saem.org]

• Persistent Vomiting

  Metabolic alkalosis can be seen in patients with persistent vomiting. Hematocrit may be elevated in severe dehydration. [saem.org]

  Recommendations In absence of signs of strangulation and history of persistent vomiting or combined CT-scan signs (free fluid, mesenteric edema, small-bowel feces sign, devascularization) patients with partial ASBO can be managed safely with NOM and tube [wjes.biomedcentral.com]

• High-Pitched Bowel Sounds

  But often the distinguishing feature can be cramping abdominal pain and hyperactive or high pitched bowel sounds. [clinicaladvisor.com]

  The classic physical examination findings of abdominal distension, tympany to percussion, and high-pitched bowel sounds suggest the diagnosis. [aafp.org]

  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]

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]

The workup should distinguish mechanical obstruction from ileus, determine the cause of the obstruction, and differentiate partial (low-grade) from complete (high-grade) obstructions. [east.org]

• Bowel Distention

  […] palpable Abdominal Distention and tympany on percussion Indicates distal obstruction Abdominal Distention has greatest PPV Rectal examination for blood IX. [fpnotebook.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]

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]

[…] and 1 had required surgical treatment) ( Table 2 ). [cmaj.ca]

Outlook (Prognosis) The outcome depends on the cause of the blockage. Most of the time, the cause is easily treated. [nicklauschildrens.org]

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%. [25] Cases of SBO related to cancer are more complicated and require [en.wikipedia.org]

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]

Obstruction not associated with cancer has a very good prognosis, especially in otherwise healthy people. [drugs.com]

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]

Etiology infection infective enteritis eosinophilic enteritis ischemia inflammatory bowel disease radiation radiation enteritis lymphoma intramural hemorrhage shocked bowel vasculitides portal hypertension hypoproteinemia sprue scleroderma systemic lupus [radiopaedia.org]

ADVERTISEMENT CT determines the location – and sometimes the etiology – of obstruction. [epmonthly.com]

“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]

A decision to prescribe empiric antibiotic therapy should rest on clinical or epidemiologic features of the illness that suggest a treatable bacterial origin or a high-risk host. [ncbi.nlm.nih.gov]

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]

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]

Pathophysiology Ileus mechanism is complex but thought to be multifactorial, including stress induced sympathetic (inhibitory) reflexes, inflammatory mediators and effects of medications. [clinicaladvisor.com]

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]

Peritoneal adhesions：etiology， pathophysiology， and clinical significance. Recent advances in prevention and management［J］. Dig Surg， 2001， 18： 260 273. ［3］ 张连阳． 粘连性肠梗阻的治疗进展［J］． 局解手术学杂志， 2005， 14： 1． ［4］ 张建宇， 傅 颖． 自拟肠粘连缓解汤加泛影葡胺治疗粘连性肠梗阻的疗效观察［J］. [cjir.paperonce.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]

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]

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]

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]

Prevention methods for enteritis include proper food preparation, hygiene, and cleanliness. [medicalnewstoday.com]