Intestinal Obstruction
An absence of peristalsis in the intestines due to various causes. Left untreated, an intestinal obstruction can lead to death.
- Obstruction prevents passage of stool/gas.
- Compaction of accumulated products (loud bowel sounds!).
- Dilation of intestines due to fermenting food and gas.
- Compression of veins and arteries (edema of intestinal wall).
- Bacterial colonization of intestines.
- Necrosis of intestinal wall.
- Perforation of intestinal wall (fever, abdominal guarding).
- Peritonitis.
Causes of Intestinal Obstruction
Mechanical causes arises primarily in the small intestines and include:
- Objects such as fecal impaction (opioid use), tumor, adhesions.
- Volvulus— intestine twisting on itself (usually elderly).
- Intussusception— telescoping intestine slides into adjacent part (usually infants).
- Strangulated inguinal hernia.
Bowel ischemia as sequelae to other conditions, including:
- Septic shock.
- Hypovolemic shock.
Non-mechanical causes are primarily neuromuscular (paralytic ileus) and include:
- Post-surgical SNS inhibition of motility.
- Hypokalemia.
- Pancreatitis.
- Peritonitis.
- Diabetic neuropathy of GI tract.
Assessment of Intestinal Obstruction
Signs and symptoms of an obstruction are usually vague.
- Nausea and vomiting due to fluid accumulation in up