The signs and symptoms of small bowel obstruction include the following:
Prompt diagnosis of the condition is required in order to prevent complications from setting in. A physical examination will be performed to hear out the bowel sounds from the stomach. No bowel sounds indicate paralytic ileus. On the other hand, if very hyperactive bowel sounds are heard they are indicative of mechanical obstruction.
In addition to physical examination, various imaging studies such as CT scan , MRI, radiography and X-ray will be carried out to study the abdominal structures and confirm diagnosis. Contrast enhanced abdominal CT may reveal the small bowel feces sign indicative of low grade partial obstruction that could still be managed conservatively .
A complete blood work also has to be carried out to study blood urea nitrogen, white blood cells count, and hematocrit. Urine analysis and lactose dehydrogenase tests are also done. It is important to rule out certain underlying disease conditions such as biliary or hepatic disease and therefore several tests governing these also have to be carried out.
Treatment of small bowel obstruction is geared towards the nature and type of obstruction. Patients with no signs of strangulation and vomiting supported with the characteristic signs of partial small bowel obstruction may be managed medically .
Non-operative patients may be managed by adequate fluid resuscitation and naso-gastric drainage which can help patients to recover spontaneously within 72 hours in a majority of cases . Medications however form the primary basis of the treatment regime and surgery may have to be opted for when the situation gets severe.
Whichever be the case, hospitalization would be required in order to stabilize the patient’s condition, after which treatment would be initiated. The following are the modes carried out for treating small bowel obstruction:
The prognosis is usually good if diagnosis is made on time and prompt treatment is carried out. If cases of complete obstructions are treated with medications, then the patients fully recover but the chances of recurrence of the obstruction are higher than those treated with surgery.
Partial obstructions are successfully treated with medications and the chances of recurrence are low. Morbidity and mortality profile of the disease depends on how soon the diagnosis was made and treatment initiated.
It has been estimated that if the obstructions are left untreated then it causes death in 100% of cases. If the surgery is performed within 36 hours then the mortality rate is as low as 8%. However, if the surgery is postponed beyond 36 hours, then the mortality rate rises to 25%.
Untreated small bowel obstruction can present the following life threatening complications:
Small bowel obstruction can be mechanical or non-mechanical in nature. In the mechanical type, some foreign body blocks the passage of intestinal contents making it difficult for its passage through the intestine.
In the latter type, there is no mechanical obstruction, but non–functioning small intestine does not allow the contents to move through the digestive system.
Non–mechanical obstruction is also known as paralytic ileus or pseudoobstruction. Children and infants are common victims of such type of obstruction.
The causes of mechanical obstruction have been explained below:
Small bowel obstruction is a common phenomenon with abdominal surgery being the root cause for majority of the cases. Statistics reveal that as high as 300,000 laparotomies every year were carried out to treat small bowel obstruction. Males and females are at an equal risk for contracting this disease condition.
Small bowel obstruction can be partial or complete; with the complete one being a life threatening condition. Under normal circumstances, the small intestine carries out the function of absorption of nutrients from the food that is digested.
When there is an obstruction, there is proximal dilation of the intestine due to buildup of stomach contents and fluid. The dilation further stimulates the cell secretion activity which leads to buildup of more fluid. This is in turn causes peristalsis above and below the area of obstruction resulting in loose motions and flatulence in the preliminary stages. If the obstruction is in the proximal levels then individuals experience vomiting.
Small bowel obstruction (SBO), a type of intestinal obstruction, is a blockage in the small intestine that prevents the passage of the intestinal contents. This leads to accumulation of stool, fluid and gas inside the intestine causing discomfort.
The obstruction can be either partial or complete. If urgent medical attention is not provided then the condition can turn life threatening. In certain cases, medications for 2 to 5 days can do the job; whereas in some other cases, surgical procedures have to be employed to remove the obstacle.
Obstruction occurring in the small intestine which prevents the emptying of the stomach contents is defined as small bowel obstruction. Obstruction can either be partial or complete in nature. There are 2 types of obstruction; namely mechanical and non–mechanical. Mechanical obstruction occurs due to obstruction usually created by foreign particles that have been swallowed. Non–mechanical obstruction is the result of a non - functional small intestine, a condition also known as paralytic ileus.
Diagnosis of the disease includes a physical examination geared towards studying the bowel sounds. In addition, imaging studies such as CT scan, MRI, and X- ray also may have to be carried out to study the intestinal structures. Blood work to test presence of underlying disease condition and also to study the hemoglobin, white blood cells and blood urea nitrogen also needs to be done.
Treatment of small bowel obstruction requires hospitalization following administration of intravenous fluids to compensate for the fluid loss. Post this, a tube is inserted through the mouth or nose in order to expel out the accumulated gas. Surgical procedures may be required in severe cases.