Bowel Obstruction

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Introduction

 

 

 

The Case of...

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Causes and Risk Factors

Adhesions and hernias are the most common causes.

 

Large bowel obstruction tends to occur in the older population. Most occur in the sigmoid colon, where the lumen is narrower. Causes include primary or metastatic cancer, diverticulitis, volvulvus, ischemia, or adhesions.

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Pathophysiology

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Signs and Symptoms

  • history
  • physical exam

History

 

Physical Exam

 

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Investigations

  • lab investigations
  • diagnostic imaging

Lab Investigations

Diagnostic Imaging

Stepladder appearance on AXR in small bowel obstruction, or string of pearls - small bubbles of gas trapped between folds.

 

Large bowel obstruction

Dilated loops of colon >6cm or cecum >8 cm may be seen. The cecum dilates to the greatest extent, regardless of site of obstruction.

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Differential Diagnosis

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Treatments

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Consequences and Course

The large bowel has a high risk of perforation when the cecum is >10cm

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Resources and References

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Topic Development

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