An intestinal obstruction is a potentially serious condition in which the intestines are blocked. The blockage may be either partial or complete, occurring at one or more locations. Both the small intestine and large intestine, called the colon, can be affected.
Obstruction frequently causes abdominal pain, nausea, vomiting, constipation-to-obstipation, and distention. This, in turn, prevents the normal movement of digested products. Small bowel obstructions (SBOs) are more common than large bowel obstructions (LBOs) and are the most frequent indication for surgery on the small intestines.
The blockage may be either partial or complete, occurring at one or more locations. Both the small intestine and large intestine, called the colon, can be affected. When a blockage occurs, food and drink cannot pass through the body. Obstructions are serious and need to be treated immediately.
Search term Bowel Obstruction David A. Smith; Sarang Kashyap; Sara M. Nehring. Author Information Authors David A. Smith1; Sarang Kashyap2; Sara M. Nehring3. Affiliations 1Salus University/PVAMC 2Easton Hospital 3St Bernards Medical Center Last Update: August 6, 2021. Continuing Education Activity
ANS: C Intussusception is the telescoping or invagination of one portion of the intestine into another section of intestine. Usually, the ileum invaginates the cecum and part of the ascending colon by collapsing through the ileocecal valve. The other terms are not used to describe this event.
ANS: B Based on these data, the nurse should suspect intussusception. A single normal stool may be passed, evacuating the colon distal to the apex of the intussusception. After passing a normal stool, 60% of infants will pass "currant jelly" stools, which appear dark and gelatinous because of their blood and mucus content. Intussusception is the only option that describes the symptoms listed
An intestinal obstruction is a potentially serious condition in which the intestines are blocked. The blockage may be either partial or complete, occurring at one or more locations. Both the small intestine and large intestine, called the colon, can be affected. When a blockage occurs, food and drink cannot pass through the body.
volvulus: twisting of the intestines. intussusception: “telescoping,” or pushing of one segment of intestine into the next section. malformations of the intestine occurring in newborns. tumors within the small intestine. gallstones, which can — but rarely do — cause obstructions.
An intestinal blockage can be an emergency, especially if the intestine is twisted, because it can cut off the blood supply and cause part of the intestine to die. Dehydration can also be a dangerous complication and can lead to organ failure, shock, and death.
Causes for paralytic ileus include: abdominal or pelvic surgery. infections, such as gastroenteritis or appendicitis. some medications, including opioid pain medications, antidepressants, and antimuscarinics. decreased potassium levels. mineral and electrolyte imbalances. Intestinal pseudo-obstruction can be caused by:
For partial obstructions or an ileus, it may be possible to treat by simply resting the bowels and giving intravenous (IV) fluids. Bowel rest means you’ll be given nothing to eat, or clear liquids only, during that time. Treating dehydration is important. IV fluids may be started to correct electrolyte imbalance.
They may even require surgery. There are a variety of causes for intestinal obstructions. These can include: scar tissue in the abdomen. twisting of the intestines.
Intestinal pseudo-obstruction can be caused by: Parkinson’s disease and other nerve and muscle disorders. Hirschsprung’s disease, which is a lack of nerves in a section of intestine in newborns. other neuromuscular disorders. disorders that cause neuropathy, such as diabetes mellitus.
A bowel obstruction can either be a mechanical or functional obstruction of the small or large intestines. The obstruction occurs when the lumen of the bowel becomes either partially or completely blocked. Obstruction frequently causes abdominal pain, nausea, vomiting, constipation-to-obstipation, and distention.
In general, when bowel obstruction is managed non surgically the recurrence rate is much higher than those treated surgically.
However, if surgery is undertaken within 24-48 hours, the mortality rates are less than 10%. Factors that determine the morbidity include the age of patient, comorbidity, and delay in treatment. Today, the overall mortality of bowel obstruction is still about 5%-8%. [3][10][Level 3]
A closed-loop obstruction refers to a type of obstruction in the small or large bowel in which there is complete obstruction distally and proximally in the given segment of the intestine. [1][2][3] Etiology. There are many potential etiologies of small ...
Although bowel obstruction alone can be suspected with an accurate patient history and presentation, the current standard of care to confirm the diagnosis in small and large bowel obstruction is an abdominal CT with oral contrast. CT allows for visualization of the transition point, the severity of obstruction, potential etiology, and assessment of any life-threatening complications. This information enables the provider to be more effective in identifying patients who will require surgical intervention. Laboratory evaluation is essential to evaluate for any leukocytosis, electrolyte derangements that may be present as a result of the emesis. Labs also evaluate for elevated lactic acid that may be suggestive of sepsis or perforation, which at times may not be visible on CT if it is a microperforation and early in the course, blood cultures, or other signs of sepsis/septic shock. Although the lactic acid is often looked to in order to determine if there is a sign of perforation or ischemic gut, it should be noted this can be normal even with a microperforation present, initially. Physical examination of the patient remains an essential diagnostic tool regarding the patient's severity and the need for emergent surgery vs. medical management. [8]
The most common cause of SBOs in industrialized nations is from extrinsic sources, with post-surgical adhesions being the most common.
The key to preventing the high mortality following a bowel obstruction is the early diagnosis, resuscitation, and operative intervention. An interprofessional team is vital to ensure that the patient receives prompt attention. The triage nurse must be fully aware of the signs of bowel obstruction and expedite the admission. The emergency physician, nurse practitioner, or physician assistant must examine the patient and get the appropriate radiological test. The surgeon must be consulted even if no intervention is planned. While awaiting surgery, the bowel may need to be decompressed with a nasogastric tube, and the nurse is essential for monitoring of vital signs and worsening of the obstruction. Communication between healthcare workers is critical. [9][4][Level V]