Questions and Answers
What is a potential complication of intestinal obstruction related to the body's fluid balance?
Which electrolyte disturbance could potentially arise from an intestinal obstruction?
Which investigation would be most appropriate to assess for bowel ischemia in a patient suspected of having intestinal obstruction?
Which method is used to initially visualize the bowel in cases of suspected intestinal obstruction?
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In the management of intestinal obstruction, what is the primary focus of initial investigations?
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Which of the following is NOT a type of intestinal obstruction?
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What is a common mechanical cause of small bowel obstruction?
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Which of the following is classified as a benign type of intestinal obstruction?
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What type of obstruction involves the impairment of passage due to dysfunction of bowel motility?
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Which condition is associated with large bowel obstruction and involves twisting of the bowel?
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In the pathophysiology of intestinal obstruction, what is a consequence of intestinal distention?
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Which of the following is a likely functional cause of small bowel obstruction?
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Which option describes a possible complication of intestinal obstruction?
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Which type of obstruction is characterized by complete loss of bowel content passage?
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What should be closely monitored in a patient with large bowel obstruction?
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Which of the following conditions is more likely to cause functional large bowel obstruction?
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What is the primary diagnostic hallmark of intestinal obstruction?
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What is a common surgical complication of untreated intestinal obstruction?
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Study Notes
Definition of Intestinal Obstruction
- Intestinal obstruction occurs when there is an impairment in the passage of intestinal contents, leading to a lack of normal propulsion and movement through the gastrointestinal (GI) tract.
Types of Intestinal Obstruction
- Small Bowel vs. Large Bowel
- Acute vs. Chronic
- Benign vs. Malignant
- Mechanical vs. Functional (ileus)
- Complete vs. Partial obstruction
Etiology of Small Bowel Obstruction
-
Mechanical Causes
- Adhesions from previous surgeries
- Hernias
- Intussusception
- Mickle’s diverticulum
- Tumors in the small bowel
- Peritoneal carcinomatosis
-
Functional Causes
- Post-operative ileus
- Medications affecting gut motility
- Electrolyte disturbances
- Inflammatory conditions
Etiology of Large Bowel Obstruction
-
Mechanical Causes
- Cancer
- Diverticulitis
- Volvulus (twisting of bowel)
-
Functional Causes
- Ogilvie syndrome (acute colonic pseudo-obstruction)
Pathophysiology
- Accumulation of intestinal gas and fluid
- Bacterial overgrowth in the affected bowel segment
- Compromised intestinal blood flow
- Increased intestinal distention and pressure
- Decreased intestinal motility leading to further complications
Clinical Presentation
- Key symptoms:
- Vomiting
- Abdominal pain
- Abdominal distension
- Constipation (severe cases leading to obstipation)
Complications of Intestinal Obstruction
- Dehydration due to fluid loss
- Electrolyte imbalances
- Bowel ischemia due to interrupted blood supply
- Risk of perforation, leading to peritonitis
Management Strategies
-
Investigations
- Laboratory tests: Complete blood count (CBC), Urea & Electrolytes (U&E)
- Imaging studies:
- Abdominal X-ray (erect/supine)
- CT abdomen/pelvis with contrast to identify transition zone, masses, ischemia, or fluid accumulation
Summary
- Intestinal obstruction can be classified based on location, duration, and nature, with varying etiologies emphasizing the need for comprehensive diagnostic and management strategies to prevent complications.
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Description
This quiz covers the essential aspects of intestinal obstruction, including its definition, types, and etiology. Designed for 4th-year general surgery students, it aims to enhance understanding and retention of critical concepts in surgical education.
