He re-presented in 2009 (six years after initial presentation) with very severe acute abdominal pain and vomiting. He had no recent change in weight or appetite, and had not had time off work. [ingentaconnect.com]

A patient presenting with gallstone ileus was managed in our department by laparoscopic enterolithotomy. Postoperatively, the patient developed recurrent small bowel obstruction due to the presence of a second gallstone. [ncbi.nlm.nih.gov]

We present a rare case of left paraduodenal hernia presenting as recurrent intestinal obstruction, as well as a brief review of the literature. [webmedcentral.com]

In 9 of 20 patients that received abdominal CT scans, “whirlpool sign” on the CT scan was present. [journals.plos.org]

• Anorexia

  There was no history of any abdominal surgery, no history of weight loss, anorexia, menstrual cycles were also normal. [file.scirp.org]

  In the chronic form, DIOS can present in a more indolent fashion with symptoms such as anorexia, colicky abdominal pain, abdominal distension, fatty stools and constipation. [cfmedicine.com]

• Acute Abdomen

  In the setting of an acute abdomen, surgery is necessary to remove the phytobezoar and ensure it does not recur. [omicsonline.org]

  About 15% of the patients admitted for acute abdomen have intestinal obstruction and small bowel obstruction accounts for 80% of these cases worldwide3. [medical-dictionary.thefreedictionary.com]

  Merck Manual Professional Version. http://www.merckmanuals.com/professional/gastrointestinal-disorders/acute-abdomen-and-surgical-gastroenterology/ileus. Accessed Sept. 18, 2015. [mayoclinic.org]

  Plain radiograph of the abdomen is the most valuable initial diagnostic test in acute SBO. [ncbi.nlm.nih.gov]

  Abdominal masses may possibly be felt but even a large mass may be missed in a grossly distended abdomen. If strangulation or perforation occurs there will be features of an acute abdomen with peritonism. Check hernial orifices. [patient.info]

• Chronic Abdominal Pain

  These patients often present with chronic abdominal pain and vomiting with or without signs of intestinal obstruction or strangulation. Diagnosis requires a high index of suspicion. [ispub.com]

  Symptoms of metastasis of MM to the small intestine include chronic abdominal pain with features of intestinal obstruction [ 7 ]. [pubs.sciepub.com]

  […] small-bowel obstruction, chronic abdominal pain, pelvic pain, and infertility. [27] 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]

  Links The role of laparoscopic adhesiolysis in the treatment of patients with chronic abdominal pain or recurrent bowel obstruction. Shayani V, Siegert C, Favia P. [laparoscopyhospital.com]

  View Article Google Scholar Swank DJ, Swank-Bordewijk SC, Hop WC, van Erp WF, Janssen IM, Bonjer HJ, Jeekel J: Laparoscopic adhesiolysis in patients with chronic abdominal pain: a blinded randomised controlled multi-centre trial. [wjes.biomedcentral.com]

• Abdominal Mass

  Clinically, these patients with abdominal cocoon present with attacks of colicky pain abdomen, nausea, vomiting with intestinal obstruction that is seldom complete. An abdominal mass may or may not be present [4]. [file.scirp.org]

  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]

  Abdominal masses may possibly be felt but even a large mass may be missed in a grossly distended abdomen. If strangulation or perforation occurs there will be features of an acute abdomen with peritonism. Check hernial orifices. [patient.info]

• 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]

• Recurrent Abdominal Pain

  A 3-dimensional CT scan was needed to explain the cause of the recurrent abdominal pain, and the small bowel loop was freed from the connecting tube at laparoscopy. [ncbi.nlm.nih.gov]

  Paraduodenal hernia presenting as unexplained recurrent abdominal pain. Am J Gastroenterol, 1999,94 : 3614-5. 2. Manji R., Warnock G. L. Left paraduodenal hernia : an unusual cause of small bowel obstruction. Can j surg, 2001, 44 : 455-7. 3. [webmedcentral.com]

• Jaundice

  Complications may include or may lead to: Electrolyte (blood chemical and mineral) imbalances Dehydration Hole (perforation) in the intestine Infection Jaundice (yellowing of the skin and eyes) If the obstruction blocks the blood supply to the intestine [medlineplus.gov]

  Possible Complications Complications may include or may lead to: Electrolyte (blood chemical and mineral) imbalances Dehydration Hole (perforation) in the intestine Infection Jaundice (yellowing of the skin and eyes) If the obstruction blocks the blood [mountsinai.org]

  Examination General •Vital signs: P, BP, RR, T, Sat •dehydration •Anaemia, jaundice, LN •Assessment of vomitus if possible •Full lung and heart examination Abdominal •Abdominal distension and it’s pattern •Hernial orifices •Visible peristalsis •Cecal [slideshare.net]

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]

Chronic pancreatitis requires an adequate diagnostic workup and systematic management, given its severity, frequency, chronicity, and negative impact on the quality of life and life expectancy. © Georg Thieme Verlag KG Stuttgart · New York. [ncbi.nlm.nih.gov]

Recognition of risk factors can aid in the timely workup and diagnosis of an ill patient with bowel obstruction. [emdocs.net]

• Bowel Distention

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

  Abdominal imaging of patients with early postoperative SBO shows gaseous distention of the bowel and a paucity of air in the colon. [clinicaladvisor.com]

• Colonic Stricture

  This excludes congenital stricture or stenosis of intestine (751.1-751.2). This applies to enterostenosis, obstruction of intestine or colon, occlusion of intestine or colon, stenosis of intestine or colon, and stricture of intestine or colon. [healthresearchfunding.org]

METHODS: After conservative treatment, elective laparoscopic treatment was attempted in 17 patients hospitalized for recurrent small bowel obstruction after abdominal or pelvic surgery. [ncbi.nlm.nih.gov]

Management Nonoperative treatment Nonoperative treatment for several types of SBO are as follows: Malignant tumor - Obstruction by tumor is usually caused by metastasis; initial treatment should be nonoperative (surgical resection is recommended when [emedicine.medscape.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%. [25] Cases of SBO related to cancer are more complicated and require [en.wikipedia.org]

After surgery, more than 90% of the patients can expect to have a favorable prognosis. [journals.plos.org]

Metastatic melanoma has a very poor-prognosis. The averages mean survival being 6 to 8 months [ 22 ]. [pubs.sciepub.com]

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

] The prognosis of advanced carcinoma of the colon remains poor. [patient.info]

The etiology included adhesions (38%), incarcerated ventral incisional hernias (32%), Meckel diverticulum (7%), stricture (14%), volvulus (3%), intussusception (4%). [ncbi.nlm.nih.gov]

We discuss the etiology and treatment of small bowel carcinoma. This case emphasizes that a high level of suspicion is required in order to diagnose early stage small bowel adenocarcinoma in celiac patients. [annalsgastro.gr]

Patient was put on antitubercular treatment for nine months keeping in mind possibility of tubercular etiology and after that ileostomy closure was done and patient made uneventful recovery with more than 8 months follow up. [file.scirp.org]

Abbreviations AF Attributable fraction AFe Attributable fraction in the exposed AWD Acute watery diarrhoea CHERG Child Health Epidemiology Reference Group of UNICEF and the World Health Organization (now MCEE—Maternal Child Epidemiology Estimation Group [ncbi.nlm.nih.gov]

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]

The Pathophysiology is said to involve the local stimulation, damage and attempts at repair by the mucosa in patients using NSAIDs for a long time ( 4 ). [academic.oup.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]

Andrus CH, Ponsky JL (1988) Bezoars: classification, pathophysiology, and treatment.Am J Gastroenterol 83: 476-478. [omicsonline.org]

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]

Ramsey-Stewart, G., Shun, A.: Nasogastrointestinal intraluminal tube stenting in the prevention of recurrent small bowel obstruction. Aust. N.Z. J. [link.springer.com]

Use of an intraluminal tube stent in preventing recurrent small bowel obstruction due to adhesions is safe and effective when used on appropriately selected patients. Its effectiveness should be more widely recognized. [ncbi.nlm.nih.gov]

Fluids are important for keeping your skin, eyes and the lining of your mouth moist, and for preventing dehydration. Surgery and the Vicious Cycle Our experience has shown us that surgery is not the solution for preventing future obstructions. [clearpassage.com]

In two children, the adhesions were so dense in the first instance and the intestinal stenting was done to prevent further small bowel obstruction. [jiaps.com]