Bowel Obstruction and Complications Quiz

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What happens to absorption and lymphatic drainage when intraluminal pressure exceeds capillary and venous pressure in the bowel wall?

They decrease (correct)

They fluctuate unpredictably

They are unaffected

They increase significantly

What is a potential consequence of bacteria entering the bloodstream due to bowel ischemia?

Enhanced lymphatic drainage

Increased peristaltic waves

Development of septicaemia (correct)

Rapid absorption of nutrients

Which type of obstruction allows for the most rapid sequence of complications?

Ileus

Partial obstruction

Non-mechanical obstruction

Closed-loop obstruction (correct)

Which clinical feature is most indicative of peritonitis in patients with bowel obstruction?

Severe abdominal tenderness Signup and view all the answers

What type of bowel sounds are typically produced in cases of mechanical obstruction?

Active, high-pitched sounds with rushes Signup and view all the answers

What is the risk associated with allowing bowel obstruction to progress significantly?

Mortality approaching 70 percent Signup and view all the answers

What symptom is common in both elderly and younger patients with intestinal obstruction?

Abdominal pain Signup and view all the answers

What indicates that a patient may be suffering from an adynamic ileus?

Diminished or absent bowel sounds Signup and view all the answers

What type of bowel obstruction pain is often described as crampy and intermittent?

Mechanical SBO Signup and view all the answers

Which condition is more likely to cause large bowel obstruction in elderly patients?

Carcinomas Signup and view all the answers

What symptom is associated with adynamic ileus?

Episodic pain lasting minutes Signup and view all the answers

What should be examined in patients with abdominal pain or distension?

Signs of organomegaly or masses Signup and view all the answers

Which treatment measure is typically effective in managing adynamic ileus?

Intravenous hydration and decompression Signup and view all the answers

What finding has been reported as a reliable sign of sigmoid volvulus?

Emptiness of the left iliac fossa Signup and view all the answers

What should be discontinued in patients with bowel obstruction?

Medications that inhibit bowel mobility Signup and view all the answers

Which of the following is commonly used to distinguish bowel obstruction from ileus?

CT contrast radiography Signup and view all the answers

What is the most common cause of small bowel obstruction following abdominal surgery?

Adhesions Signup and view all the answers

Which factor is a common cause of mechanical obstruction in the intestines?

Intrinsic or extrinsic factors Signup and view all the answers

What is adynamic ileus primarily characterized by?

Self-limiting disorder Signup and view all the answers

Which condition is most likely to present as small bowel obstruction due to intussusception?

Lymphomas Signup and view all the answers

What are bezoars most commonly composed of?

Vegetable matter or pulp from persimmons Signup and view all the answers

In patients who have undergone radiation therapy, which condition is a possible cause of small bowel obstruction?

Radiation enteritis Signup and view all the answers

What is the second most common cause of small bowel obstruction?

Incarceration of a groin hernia Signup and view all the answers

Colonic obstruction is almost never caused by which factor?

Hernias Signup and view all the answers

What is the most common cause of large bowel obstruction (LBO)?

Neoplasms Signup and view all the answers

Which of the following hernias are more readily apparent and can occur in any age group?

Umbilical hernias Signup and view all the answers

Which patient demographic is particularly susceptible to femoral or medial thigh pain from hernias?

Elderly females Signup and view all the answers

After cancer and diverticulitis, what is the next most frequent cause of large bowel obstruction?

Sigmoid volvulus Signup and view all the answers

In which situation can gallstone ileus occur?

When a gallstone erodes from the bowel Signup and view all the answers

Which type of obstruction is most often seen in elderly, bedridden, or psychiatric patients taking anticholinergic medication?

Mechanical obstruction Signup and view all the answers

Which condition may precede the development of sigmoid volvulus?

History of constipation Signup and view all the answers

Which type of primary small bowel lesion is considered unusual for causing intraluminal obstruction?

Celiac disease Signup and view all the answers

What is the role of a pelvic examination in diagnosing bowel obstruction?

To rule out gynecologic pathology Signup and view all the answers

What condition may mimic bowel obstruction and is often characterized by the presence of gas in the intestines?

Intestinal pseudo-obstruction Signup and view all the answers

What indicates a need for surgical intervention in cases of bowel obstruction?

Confirmed mechanical obstruction Signup and view all the answers

Why is the use of barium studies avoided in patients suspected of having bowel obstruction?

Patients may be unable to evacuate the barium Signup and view all the answers

What treatment should be considered for decompression of intestinal pseudo-obstruction?

Colonoscopy Signup and view all the answers

What preparation is recommended prior to surgical intervention for bowel obstruction?

Insertion of a nasogastric tube Signup and view all the answers

What is a common characteristic of bowel obstruction seen on radiographs?

Dilated colon with sepata and haustral markings Signup and view all the answers

Which medication type may decrease bowel motility and potentially contribute to obstructions?

Anticholinergics and Tricyclic antidepressants Signup and view all the answers

What is typically the nature of vomitus in proximal bowel obstruction?

Bilious Signup and view all the answers

Which symptom is associated with complete bowel obstruction?

Vomiting Signup and view all the answers

In distal ileal obstruction, what is the characteristic nature of the vomitus?

Feculent Signup and view all the answers

What leads to volume depletion in bowel obstruction cases?

Decreased absorption and vomiting Signup and view all the answers

Which clinical finding is NOT characteristic of bowel obstruction?

Regular bowel movements Signup and view all the answers

What is one consequence of untreated bowel obstruction?

Renal failure Signup and view all the answers

Which of the following findings can increase in bowel obstruction?

Intramural pressure Signup and view all the answers

How does partial bowel obstruction differ from complete obstruction regarding stool passage?

Stool may be passed regularly in partial obstruction Signup and view all the answers

Study Notes

Intestinal Obstruction

Intestinal obstruction is the inability of the intestinal tract to allow normal food and bowel passage.
This can be mechanical (obstruction) or adynamic (paralytic).
Adynamic ileus is usually self-limiting and doesn't need surgery.
Mechanical obstruction requires intervention to identify and treat the cause, minimizing complications.

Small Bowel Obstruction (SBO)

Common causes: Adhesions (following surgery), incarcerated groin hernias (in infants and adults), hernias at umbilicus, femoral, or obturator foramens.
Umbilical hernias are more easily identifiable and can occur in any age group.
Less common causes: small bowel lesions (polyps, lymphoma, adenocarcinoma), gallstone ileus (gallstone in bowel), bezoars (vegetable matter or pulp), inflammatory bowel disease, infectious processes, and radiation enteritis.

Large Bowel Obstruction (LBO)

Common cause: Neoplasms (tumors).
Other causes: diverticulitis, stricture formation due to inflammation and scarring, fecal impaction (common in elderly), sigmoid volvulus (common in elderly, bedridden, or psychiatric patients taking anticholinergics), and cecal volvulus (higher incidence in pregnant patients).

Pathophysiology

Normal bowel contains gas, secretions, and food.
Obstruction leads to congestion, impaired absorption, vomiting, decreased oral intake, and fluid/electrolyte imbalance, possibly leading to renal failure or shock.
Distension occurs due to fluid and air build-up.
Severe obstruction causes ischemia (lack of blood flow) resulting in bowel necrosis and the possibility of sepsis.

Clinical Features

Pain: Crampy and intermittent in proximal SBO; often more intense and constant in distal SBO.
Vomiting: Bilious in proximal SBO, feculent (containing digested matter) in distal SBO or LBO.
Inability to pass stool or flatus: Indicates possible obstruction, but constipation could have other causes.
Physical findings: Usually abdominal tenderness (potentially severe or localized), distension. Distension is often more noticeable with LBO.
Elderly patients with obstruction may exhibit various symptoms

Treatment

Mechanical obstruction: Often requires surgery.
Nasogastric tube: To remove contents, improve symptoms, and reduce distention.
Intravenous fluids: To correct fluid and electrolyte imbalances
Broad-spectrum antibiotics: Reduce risk of infection.
Conservative measures (adynamic ileus): IV fluids, nasogastric suction, and observation.
Surgery is typically considered for patients with mechanical obstruction, potentially including endoscopic interventions or surgical procedures to remove the obstruction.

Pseudo-obstruction (Ogilvie syndrome)

Mimics bowel obstruction, but is functional, not mechanical
Characterized by significant colonic dilation, which is highlighted in radiographic images.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on the physiological effects and clinical features associated with bowel obstruction. This quiz covers topics such as absorption, lymphatic drainage, and complications arising from different types of obstructions. Assess your understanding of how bowel ischemia can lead to severe health issues.