Bowel obstruction

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Bowel obstruction is a mechanical or functional obstruction of the intestines, preventing the normal transit of the products of digestion. It can occur at any level distal to the duodenum of the small intestine and is a medical emergency. Although many cases are not treated surgically, it is a surgical problem.

Differential Diagnosis of Causes of Bowel Obstruction

By Localization

Small bowel obstruction

Large bowel obstruction

Causes of large bowel obstruction include:


By organ system

  • Miscellaneous syndromes
  • Chromosomal abnormalities
  • Autosomal dominant conditions
  • Malignant neoplastic conditions
  • Trauma, mechanical and physical conditions
  • Infectious disorders

By mechanism

Mechanical Obstruction

Non-Mechanical Obstruction

Pseudo-Obstruction

  • Aerophagia
  • Functional bowel disease

Signs, symptoms and causes

Depending on the level of obstruction, bowel obstruction can present with abdominal pain, abdominal distension, vomiting, fecal vomiting, and constipation.

Obstruction may be due to causes within the bowel lumen, within the wall of the bowel, or external to the bowel (such as compression, entrapment or volvulus).

Bowel obstruction may be complicated by dehydration and electrolyte abnormalities due to vomiting; respiratory compromise from pressure on the diaphragm by a distended abdomen, or aspiration of vomitus; bowel ischaemia or perforation from prolonged distension or pressure from a foreign body.

In small bowel obstruction the pain tends to be colicky (cramping and intermittent) in nature, with spasms lasting a few minutes. The pain tends to be central and mid-abdominal. Vomiting occurs before constipation.

In large bowel obstruction the pain is felt lower in the abdomen and the spasms last longer. Constipation occurs earlier and vomiting may be less prominent. Proximal obstruction of the large bowel may present as small bowel obstruction.

Diagnosis

The main diagnostic tools are blood tests, X-rays of the abdomen, CT scanning and/or ultrasound. If a mass is identified, biopsy may determine the nature of the mass.


References


See also

Template:Gastroenterology


de:Darmverschluss it:Ileo (intestinale)

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